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HomeMy WebLinkAboutForm 460 - Police Association PAC (2021-06-30) Amendment Semi-AnnualRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/2021 through 06/30/2021 1. Type of Recipient Committee: All committees -Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Pail 5) 0 Sponsored ❑X General Purpose Committee (Also Complete Part 6) Q Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 83155.' COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) San Rafael Police Association Political Action Committee STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX COVERPAGE Date of election if applicable u JAI 3 1 2022 202 (Month, Day, Year) P e of For A5681 Use Only FICE2CITY CLERK'S OFFICE - 2. . Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑x Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 Amendment (Explain below) Beginning balance and Schedule A updates. Treasurer(s) NAME OF TREASURER Cynthia Morgan MAILING ADDRESS CITY STATE ZIP CODE AREA CODFJPHONE San Rafael CA 94901 ( NAME OF ASSISTANT TREASURER, IF ANY Stacy E. Owens MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94915-1557 Oakland CA 94607 ( OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the Executed on 01/23/2022 Date Executed on 01/23/2022 Dale Executed on Date Executed on Date www.neffile.com By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature ofControlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COVER PAGE- PART Page 2 of 202 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTIONI ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD I 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 BOX) ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT STATE ZIP ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CODE AREA CODE/PHONE Attach continuation sheets if necessary CITY STATE ZIP FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov www.netfile.com Campaign Disclosure Statement Amounts may be rounded Statement covers period Summary Page to whole dollars. from 01/01/2021 SEE INSTRUCTIONS ON REVERSE through 06/30/2021 NAME OF FILER San Rafael Police Association Political Action Committee Contributions Received 1. Monetary Contributions ........................................... Schedule A, Line 3 2. Loans Received...................................................... Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I+2 4. Nonmonetary Contributions .................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................••• Add Lines 3+4 Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 7. Loans Made............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE .........................,......Add Lines 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 13. Cash Receipts ........... ........................................ Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) $ 13,962.39 0.00 $ 13,962.39 0.00 $ 13■962.39 Column B CALENDARYEAR TOTALTO DATE $ Y 13,962.39 0.00 $ 13.962.39 0.00 $ 13,962.39 $ 3,713.25 $ 3,713.25 0.00 0.00 $ 3,713.25 $ 3,713.25 -659.50 719.00 0.00 0.00 $ 3,053.75 $ 4,432.25 $ 144,975.11 13.962.39 7.15 3,713.25 $ 155,231.40 17. LOAN GUARANTEES RECEIVED...... -- ............. ... Schedule a, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column 8 above www.netfile.com $ 0.00 $ 719.00 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). SUMMARY PAGE FORM - Page 3 of 202 I.D. NUMBER 831553 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 Limlt) Date of Election Total to Date (mm/dd/yy) I�$ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Q^11%^.J. ile A �Ie71:f�1�1��e1 Amounts may be rounded Statement covers period Monetary Contributions Received to Whole dollars. r 0 1 from 01/01/2021 through 06/30/2021 Page 4 of 202 SEE INSTRUCTIONS ON REVERSE 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 OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION 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) _ 01/15/2021 Elisha Adams MIND Officer 7.80 177.60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 01/31/2021 Elisha Adams (@ IND Officer 17.80 177.60 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 02/12/2021 Elisha Adams ®IND Officer 17.80 177.60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 02/26/2021 Elisha Adams RIND Officer 17.80 177.60 C/o: San Rafael Police Association 1520 Fifth ❑COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC 3 15 21 Elisha Adams M IND Officer 13.3U C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 84.50 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ............................ $ 13, 805.00 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 157.39 3. Total monetary contributions received this period. Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1. ... TOTAL $ 13, 962.39 www.netfile.com 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC— Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ � from 01/01/2021_ O through- 06/30/2021 Page 5 of 202 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 DEO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 4313017.021 Elisha Adams X❑IND Officer 13.30 177.6:D C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC 04/15/2021 Elisha Adams X❑IND Officer 13.3() 177.60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 04/30/2021 Elisha AdamsIND © Officer 13.30 177.60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY [:]SCC 05/15/2021 Elisha Adams X❑IND Officer 13.30 177.60 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC 05/31/2021 Elisha A ales X❑IND Otticer 13. sU 1 C/o: San Rafael Police Association 1520 Fifth❑COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 66.50 "Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Parry SCC— Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period e . to whole dollars. 1 from 01/01/2021 ■' through 06/30/2021 Page 6 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) � 06/15/2021 Elisha Adams X❑IND Officer 13.30 177,60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC 06/3G/2021 Elisha Adams R] IND Officer 13.30 117.60 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 01/15/2021 Alison Ager El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. SAn Rafael. CA 94901 01/31/2021 Alison Ager x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 02/12/2021 A ison AgOr ]IND Police Officer li.uu C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, Avenue,1520 Fifth L] 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$ 80.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period I CALIFORNIA to whole dollars. I ' from 01/01/2021 • through 06/30/2021 Page 7 of 202 NAME OF FILER I:O. NUMSER San Rafael Police Association Political Action Committee 831553 ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26/207.1 Alison Ager RIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 03/1$12021 Alison Ager x❑IND Police Officer 17.8U 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ;22Q Fifth Avenue San R�f­j- r.A q4c.)nl- ❑ SCC 03/30/2021 Alison Ager RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152n Fifth Avenue.e A 0 04/15/2021 Alison Ager E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael, CA 94901 4 Alison Ager RIND Police Officer 1 �• 10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael- CA 949LI ❑ SCC SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. from 01/01/2021 FORM through 06/30/2021 Page 8 of 202 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 NAMESTREET 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,ENTERNAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Alison Ager X IND Police Officer 13.30 182.1.0 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Police Officer 13.30 182.10 05/31/2021 Alison Ager X❑IND C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [:]PTY intermediary: San Rafael Police Association, IS20 Fifth Avenup., San BAfgel. CA 9a901--_ ❑ SCC 06/15/2021 Alison Ager XIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ElPTY intermediary: San Rafael Police Association, i520 Fifth Av"]je, San Rafael. CA 94901 [-]SCC 06/30/2021 Alison Ager KIND Police Officer 13.30 18E.k0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 ❑ Rau r Agri Ta -r [91 IND sergeant 17. 80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifrh Avenue, San Safael- CA 94901 ❑ SCC SUBTOTAL$ 71.00 *Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC- Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. 1 ' from 01/01/2021 ■ through 06/30/2021 Page 9 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (E COMMITTEE, ALSO 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) 01/31/2021 Raul Aguilar X❑IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael CA 94901 02/'12/2021 Raul Aguilar El IND Sergeant 17.80 1.82..10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1c;90 Fifth Avpnup- San Rafa�l_ CA 94901 ❑ SCC 02/26/2021 Raul Aguilar RIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 5 4901 03/15/2021 Raul AguilarIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Raul Aguilar E]IND Sergeant 182.10 C/o: San Rafael Police Association 1520 Fifth [-] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTy intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ayga3je. San Rafael. CA 9 SUBTOTAL$ 84.50 "Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Parry SCC -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. ■ from 01/01/2021 0 " through 06/30/2021 page 10 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 09/15/2621 Raul Aguilar X❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94.901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth venue San Rafael CA 94901 04/30/2021 Raul Aguilar El IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Raul AguilarX❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth� byenj�e. San Rafael- QA 94901 05/31/2021 Raul Aguilar E] IND Sergeant 13.30 182.1G C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 06115/2021 Raol Aguilar [91 IND Sergeant 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael. CA 919QI-- ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 4601 � , from 01/01/2021 • through 06/30L2021 page 11 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) _ 06/30/2021 Raul Aguilar X❑IND Sergeant 13.30 18:%.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 01/15/2021 James Bellamy RIND Corporal 17.80 18:?. 1_0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 James Bellamy El IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 0 Fifth Avenue,n Rafa,-1, CA 94901 02/12/2021 James Bellamy X❑IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 — U2 7R72U= 3ames Beliairy X❑IND Corporal 1 / - C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San R&fAjz21 CA 94901 ❑ SCC SUBTOTAL$ e4.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT. Page 12 of 202 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 James Bellamy X❑IND Corporal 17.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth San Rafael CA 94901 03/30/2021 -Avenue. James Bellamy ❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay�nue, SAn R�faPl CA 9420; ❑ SCC 04/15/2021 James Bellamy ©IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avpn)je, San Rafael. CA 94901 ❑ SCC 04/30/2021 James Bellamy RIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl City of San Rafael COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [—]SCC 1520 Fifth Avenue, San Rafael, CA 94901 05/15/2021 James Bellamy OIND Corporal 13.30 . C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 94901 ❑ SCC SUBTOTAL$ 71.00 "Contributor Codes IND—Individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. J � 01 from 01/01/2021 • through 06/30/2021 Page 13 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR FULL NAME, AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT OCCUPATION AND EMPLOYER RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ( COMMITTEE, ALSO LID NUMBER) CODE * (IFSELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05131 2021 James Bellamy QIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520.Fif.t,h Avenue San Rafael CA 94901 06/15/2021 James Bellamy X❑IND Corporal 13.30 18^.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Av,nu— San RAf�pl_ CA 94901 ❑ SCC 06/30/2021 James Bellamy F1 IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1S20 Fifth Avpoue. San Rafael, CA 94901 01115/2021 Todd Berringer X❑IND Sergeant 17.80 168.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 01/31/2021 Todd Berringer 91 IND Sergeant 1 b C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. Saa Rafael. CA 94311 ❑ SCC SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 1/12/2021 Todd Berringer X❑IND Sergeant C/o: San Rafael Police Association 1520 Fifth COM City of San Rafael '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 ergeant ity of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 page 14 of 202 I.D. NUMBER AMOUNT RECEIVED THIS PERIOD 17. 17.80 13.30 Sergeant ��•�� City of San Rafael SUBTOTAL$ 80.00 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 168.80 168. 168.80 168.80 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ San Rafael, CA 94901 ❑ OTH Union member's dues received through FIFTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/26/2021 Todd Berringer RIND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avgnijn_ o�an Bafapi, CA 94901 ❑ SCC 03/15/2021 Todd Berringer RIND C/o: San Rafael Police Association 1520 Fifth F1 COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth v ❑ SCC 03/30/2021 Todd Berringer EIIND C/o: San Rafael Police Association 1520 Fifth F-1ComAvenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 04/1512021 Todd Berringer [g] IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through, ❑ PTY intermediary: San Rafael Police Association, ❑ 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 ergeant ity of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 page 14 of 202 I.D. NUMBER AMOUNT RECEIVED THIS PERIOD 17. 17.80 13.30 Sergeant ��•�� City of San Rafael SUBTOTAL$ 80.00 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 168.80 168. 168.80 168.80 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALAFORNIA to whole dollars. ■ 60 from 01/01/2021 O' page 15 of 202 through 06/30/2021 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 OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITEE,ALSO ENTER ID.NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Todd Berringer MIND Sergeant 13.30i 168.80 C/O: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1,520 Fifth Avenue, San Rafael CA 94901 05/15/2021 Todd Berringer El IND Sergeant 13.30 168.87 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1'9n Fifth Aw,jQu,. San Rafaal_ CA 94901 ❑ SCC 05/31/2021 Todd Berringer MIND Sergeant 13.30 168.80 C/O: San Rafael Police Association 1520 Fifth [-]Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. 06/15/2021 Todd Berringer QIND Sergeant 13.30 168.80 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/15/2021 Zachary Eric a 91 IND Officer ii.bu 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 15213 Fifth Averlut-, San Esifae , CA 94901 ❑ 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$ 71.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period 9 . to whole dollars. I 1 from 01/01/2021 161kyj through 06/30/2021 Page 16 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Zachary BrickellX❑IND Officer 17.80 192.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/12/2021 Zachary Brickell u❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM ^ity Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through E]PTY intermediary: San Rafael Police Association, 12a Fifth Avanu— San Ra��gl C_'A 94901 ❑ SCC 02/26/2021 Zachary Brickell El IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, Sjn Rafael. 03/15/2021 Zachary Brickell QIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael, CA 94901 73/30/2021 Zachary Brickeil 91 IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY ociation, intermediary: San Rafael Police Ass94901 11520 Fifth Avenue, San Rafael, CA ❑ 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$ 84.501 FPPC Form 460 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. / from 01/01/2021 O through 06/30/2021 Page 17 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 04/15/7.021 Zachary Brickell X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Zachary Brickell X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aypoup- &an Rafael, CA 94901 ❑ SCC 05/15/2021 Zachary Brickell x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, n Rafael. CA 94901 05/31/2021 Zachary Brickell F] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM "ity Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 6! Zachary Brickell E] IND Officer 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth "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$ 66.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. 1 from 01/01/2021 through 06/30/2021 Page 18 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO .D.N OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/2021 Zachary BrickellX❑IND Officer 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021 Scott Brooks El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PT,( intermediary: San Rafael Police Association, San Rafapl_ CA 94901 ❑ SCC 01/31/2021 Scott Brooks _ x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1S2Q Fifth Avenue. 94901. 02/12/2021 Scott Brooks RIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael [-] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 02/26/2021 Scott Brooks x❑IND Police Officer . 80 C/o: San Rafael Police Association 1520 Fifth City of San Rafael El COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth ❑ SCC SUBTOTAL$ 84.50 `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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. from 01/01/2021 through 06/30/2021 Page 19 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Scott Brooks X❑IND Police Officer 1l.dU 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael CA 94901 03/30/2021 Scott Brooks X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 04/15/2021 Scott Brooks x❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Ra�apj CA 94901 ❑ SCC - 04/30/2021 Scott Brooks El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael CA 94901 82.1 05/15/2021 Cott Brooks X❑IND Police Or f icer 13_50 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aven �n. San Rafael__QA_3_420_L_ ❑ 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.neffile.com SUBTOTAL $ 71.001 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. ■ � from 01/01/2021 O' through 06/30/2021 Page 20 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT I CUMULATIVE TO DATE PER ELECTION DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 05/31/2021 Scott Brooks MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, C SCC 1520 Fifth Aven e San Rafael. CA 94901 06/15/2021 Scott Brooks MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 06/30/2021 Scott Brooks E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v n RAfRel. CA 94901 - 01J15/2021 Antonette Bullock MIND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 1 31 ntonette Bu oc MIND Community Service Orficer 13.90 142,35 C/O: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, 1520 Fifth Ave — .,�Al ❑ 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$ 67.70 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. from 01/01/2021 through 0 6130 /2021 Page 21 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ADDRESSZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Antonette Bullock X❑IND Community Service Officer 13.90 112.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue San Rafael CA 94901 02/26/2021 Antonette Bullock X❑IND Community Service Officer 13.90 142.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 03/15/2021 Antonette Bullock El IND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. CA 0 03/30/2021 Antonette Bullock MIND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 9 Antonette Bullock MIND Community Service Otticer lu.40 142,30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avpnue. San 1 SUBTOTAL$ 62.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ 60 from 01/01/2021 O through 06/30/2021 Page 22 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Antonette BullockX❑IND Community Service Officer 10.40 42.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/15/2021 Antonette Bullock MIND Community Service Officerl 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fi-fLh Av�_nup_, San Rafael. CA, 949nj ❑ SCC 05/31/2021 Antonette Bullock El IND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth Avenue. San Rafjpl. QA- 9_4_q01 06/15/2021 Antonette Bullock X❑IND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael CA 94901 _156/3012021 Antonette BullozE X❑IND Community Service Officer 1U. 4U 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 11;'20 Fifth Ayen3jg. San RafaL1j__CA__q_4qQj_ ❑ SCC SUBTOTAL$ 52.00 *Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 23 of 202 I.D. NUMBER 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IFCOMMITfEE,ALSOENTERI.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Joseph Camins x❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 01/31/2021 Joseph Camins X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Aygnug- San Rafael- CA 94901 ❑ SCC 02/12/2021 Joseph Camins El IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC h Avenue. 02/2.6/2021 Joseph Camins X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Joseph Camins 91 IND otticer 11•6 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafaal. CA 942QI- ❑ SCC SUBTOTAL$ 89.00 'Contributor Codes IND - Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC- Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. from 01/01/2021 through 06/30/2021 Page 24 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03130/2421 Joseph Camins RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Joseph Camins RIND Officer 13.30 192.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 11�9n Piff7h A­n�,p_ San Rafael. CA 94901 [:]SCC 04/30/2021 Joseph Camins X❑IND Officer 13.30 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San ZaLaej. CA 94901 []SCC 05/15/2021 Joseph Camins RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 05/311ZU21 Joseph Camins RIND Otticer li.i C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, Sap Rafael. Ck, 949Q_l ❑ SCC SUBTOTAL$ 66.50 "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 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I ' from 01/01/2021 • through 06/30/2021 Page 25 of 202 1 NAME OF FILER i.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUM ULATIVETO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED .D CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN.1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/1512021 Joseph CaminsX❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael CA 94901 06/30/2021 Joseph Camins _ MIND Officer 133.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/15/2021 Marissa Carney El IND Call Taker & Records 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. 9 01 01/31/2021 Marissa Carney MIND Call Taker & Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 02112/2021 arissaTa—rney X❑IND Call Taker & Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth Specialist ❑ COM Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC _U20 Fifth Avenue, San Rafael__CA__9A.U1 SUBTOTAL$ 68.30 '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.nefile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. from 01/01/2021 RMP through 06/30!2021 Page 26 of 202 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 DE O FULL NAME, STREET ADDRESS AND 21P CODE OF CONTRIBUTOR ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO ENTER .D.N CODE * IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26/2071 Marissa Carney x❑IND Call Taker & Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafgel, CA 94901 - 03/151'2021 Marissa Carney RIND Call Taker & Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Marissa Carney RIND Call Taker & Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [-]COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, f el 04/15/2021 Marissa Carney RIND Call Taker & Records 10.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Marissa74/30/2021 Carney RIND Call Taker & Records 10.40 142.JO C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PN ociation, intermediary: San Rafael Police Ass94501 1520 Fifth Ayenu4n. San Rafael. CA [:]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$ 59.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1 60 from 01/01/2021 • through 06/30/2021 Page 27 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/0221 Marissa CarneyX❑IND Call Taker & Records 10.40 ... C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 05/31./202.1 Marissa Carney 91 IND Call Taker & Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 1S20 Fifth Ay�nue. San Ra�ap_l- CZ� 94901 ❑ SCC 06/15/2021 Marissa Carney x❑IND Call Taker & Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue OTH City Of San Rafael San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. n R f 06/30/2021 _ Marissa Carney E] IND Call Taker & Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue San Rafael, CA 94901 [_]OTH City Of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01115/2021 Trevor Carney RIND corporal 17.80 !82.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. *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$ 59.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULEA Monetary Contributions Received Amounts may be rounded statement covers period to whole dollars. 1 from 01/01/2021 __61"Wf III *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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM through 06/30/2021 page 28 of 202 NAME OF FILER San Rafael, CA 94901 ❑ OTH I.D. NUMBER San Rafael Police Association Political Action Committer- ❑ PTY 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) x❑IND orporal 17.80 OF BUSINESS) ' ❑ COM 01/31/2021 Trevor-CarneyX❑IND Corporal 17.810 182.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ PTY *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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 520 Fifth Avenue San Rafael CA 94901 02112/2021 Trevor Carney x❑IND orporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM ity of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS2n Fifth Avgnuig, San RafaMl. PA 94901 E] SCC 02/26/2021 Trevor Carney ©IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through E❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avgnu�. Sari Rafael. CA 94901 03/15/2021 Trevor Carney ]IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 FifthE] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [❑PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94961 Trevor Carney E] IND Corporal, ljju 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, — en I— .._ems ._-___-_ .-__ .-._.1-1 , ❑ 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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. I � ' from 01/01/2021 " through 06/30/2021 Page 29 of 202 NAME OF FILER I.D. NUMBFR San Rafael Police Association Political Action Committee 831553 DATE DE O FULL NAME; STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR A RE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, .D.N IT CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 44115 2021 Trevor Carney x❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [j COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94201 04/30/2021 Trevor CarneyX❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Fifth Av�ni­. Jan aafael CA 94901 ❑ SCC 05/15/2021 Trevor Carney E] IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. CA 9901 05/31/2021 Trevor Carney E] IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue; San Rafael CA 94901 66/15 /2021 Trevor Carney x❑IND Corporal 13,30 1 .1 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, F�fth Avenue, San Rafael. ❑ SCC -"20 SUBTOTAL$ 66.50 '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 FPPC Form 460 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED(IFCOMMITTEE, ALSO ENTER I D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 66/30/2021 Trevor Carneyx❑IND Corporal C/o: San Rafael Police Association 1520 Fifth City of San Rafael "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 ricer ty of San Rafael fficer ity of San Rafael Officer City of San Rafael urricer City of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 30 of 202 J I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN- 1 -DEC. 31) (IF REQUIRED) 13.30 17.80 17.80 17.80 li.80 84.50 182.10 182.1 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑COM San Rafael, CA 94901 ❑ OTH Union member's dues received through FIFTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/20.21 Jack Carpenter El IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 Jack Carpenter x❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth &venue. San Rafael- CA, 0 02/12/2021 Jack Carpenter El IND C/o: San Rafael Police Association 1520 Fifth F] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 02/26/2021 Jack Carpenter El IND C/o: San Rafael Police Association 1520 Fifth F1 COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, —1. .._ ems .____.---__ __ ­­— .—I ❑ 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 ricer ty of San Rafael fficer ity of San Rafael Officer City of San Rafael urricer City of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 30 of 202 J I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN- 1 -DEC. 31) (IF REQUIRED) 13.30 17.80 17.80 17.80 li.80 84.50 182.10 182.1 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period• . to whole dollars. ■ � from 01/01/2021 • through 06/30/2021 Page 31 of 202 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 AMOUNT RECEIVED THIS CUM ULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSOENTERI.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC 31) (IF REQUIRED) OF BUSINESS) 03/15/20 1 Jack Carpenter x❑IND Officer 17.80 C/o: San Rafael Police Association 1520 Fifth [71 COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue San R f 1. CA 94901 03/3012021 Jack Carpenter MIND Officer 13.30 182,10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [IPTY intermediary: San Rafael Police Association, 1520 Fifth Ay—up San R;;f;;Pl. CA 1)4901 ❑ SCC 04/15/2021 Jack Carpenter MIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through - ❑ PTY intermediary: San Rafael Police Association, 152Q FifLb Avenue, San Rafapl, ❑ SCC 04/30/2021 Jack Carpenter X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 7�51 Jack Carpenter MIND Otticer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ayenue. San Rafaej. SUBTOTAL$ X1.00 'Contributor Codes IND–Individual COM– Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY–Political Party SCC–Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. ■ from 01/01/2021 • ' through 06/30/2021 page 32 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/2021 Jack Carpenter X❑IND Officer 13.3U 1;:.'.10 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 Officer 13.30 182.10 06/15/2021 Jack Carpenter x❑IND C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1S20 Fifth Av-nu­ SAo Rafael - CA c)4901 ❑ SCC 06/30/2021 Jack Carpenter x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, Sari Rafae - CA 94901 ❑ SCC 01/15/2021 Edward Chiu F1 IND Officer 17.80 162.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 Edward u X❑IND Officer 17. 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,1520 Fifth Avenue. San Rafael. [:]SCC SUBTOTAL$ 7s.so *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small ContributorCommittee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. ` from 01/01/2021 through 06/30/2021 Page 33 of 202 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 DATE (IF COMMITTEE, ALSO ENTER I D. NUMBER) QTO (IFSELPFEMP RECEIVEDPERIOD CALENDAR YEAR RECEIVED CODE * SELF-EMPLOYED, ENTER NAME IODTHIS (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Edward Chiu x❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 07./26/2021 Edward Chiu BIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/15/2021 Edward Chiu RIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue.n Rafael. 03/30/2021 Edward Chiu X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 04/1512021 1 Edward iuMINDOfficer 13.30 182.143 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 152g Fifth Ayenj;In. San RafAia-1- CA ❑ 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$ 80.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. from 01/01/2021 ■' through 0 6/30 /2021 page 34 of 202 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 TO DATE DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Edward Chiu RIND Officer (13.301 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San R fael CA 94901 - 05/15/2021 Edward Chiu RIND Officer 13.30 .182.10 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth AyQDup. &an Rafael, CA 24201 ❑ SCC 05/31/2021 Edward Chiu x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1,520 Fifth v nue. San Rafael. CA 94901 06115[2021 Edward Chiu E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthE] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenuer San Rafael, CA 94901 Edward Chiu RIND Officer 13.30 �. C/o: San Rafael Police Association 1520 Fifth City of San Rafael El COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, ❑ 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$ 66.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • � to whole dollars. 460 � ' from 01/01/2021 • ' through 06/30/2021 Page 35 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Richard F. ClaryX❑IND Police Otticer 13.90 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth Avenue San Rafael CA 94901 41/31/2021 .1520 Richard F. Claryx❑IND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/12/2021 Richard F. Clary RIND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Ayej)ue, San Rafael, CA 0 02/26/2021 Richard F. Clary E] IND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 Fifth[-] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 0 11 Tj'chard F. Clary RIND Police Officer 17.su 1!8.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth Aven1je. San Rafael- rA 94901 [:]SCC _1_520 SUBTOTAL$ 85.10 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER - D 4f ­l Dr.lirc Accnni }jnn Pnlj}jr-al Arti" r(l..itt- Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT) Page 36 of 202 I.D. NUMBER 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$ 66.50 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 13.30 03/30/2021 Richard F. Clary X❑IND Police Officer C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 94901 — Police Officer 13.30 178.2n 04/15/2021 Richard F. Clary El IND C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/30/2021 Richard F. Clary RIND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 FifLb Avenue, R a 05/15/2021 Richard F. Clary RIND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 05/31/2021 Richard F. Clary X IND Police officer is.ju 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael. CA 94901 ❑ 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$ 66.50 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Can P, -F-1 Pnlino Acs iatinn Pn1iti-1 Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 37 of 202 I.D. NUMBER 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR YEAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Richard F. Clary X❑IND Police Officer 13.30 lf8.i' C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael 94901 06/30/2021 Richard F. Clary x❑IND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 1520 Fj f ❑ SCC 01/15/2021 Robert Cleland 2] IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v an f 1 A 01/31/2021 Robert ClelanduIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 02/12/2021 Robert Cleland QIND Sergeant 1/.80 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay-enue, Sari Rafael, CA ❑ SCC _9A2D1__ SUBTOTAL$ 80.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ 60 from. 01/01/2021 FORM through 06/30/2021 Page 38 of 202 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 CONTRIBUTORCONTRIBUTOR 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) 02/26/2421 Robert Cleland X❑IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑SCC 1520 Fifth Aven e San Rafael CA 94901 Sergeant 17.80 18?.19 03/15/2021 Robert Cleland X❑IND C/O: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03130/2021 Robert Cleland RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. CA 0 04/15/2021 Robert ClelandRIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 04130/2021 Robert Glelanct E] IND Sergeant i3. U 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, CA 54901 ❑ SCC SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 SCHEDULE A (CONT.) '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov through 06/30/2021 Page 39 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IFSELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 05/15/2021 Robert ClelandX❑IND Sergeant 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/31/2021 Robert Cleland x❑IND Sergeant 13.30 :82,10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152a Fifi-h Ay�njip. Ran Rafael- CA 24901 ❑ SCC 06/15/2021 Robert Cleland ®IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Rafael.1520 Fifth Avenue. San 06/30/2021 Robert Cleland RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 115 20 21 Thomas Collins RIND Officer ii.rsu 182.10 C/o: San Rafael Police Association 1520 Fifth L] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth v ❑ SCC SUBTOTAL$ 71.00 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period _ to whole dollars. ' from 01/01/2021 • through 06/30/2021 Page 40 of 202 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 RECEIVED THIS CUM ULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) a 1131 2021 Thomas Collins MINDOfficer 17.8() i87.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 021121202.1 Thomas Collinsx❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Thomas Collins ❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v ari Rafael. CA 94901 03/15/2021 Thomas Collins '❑BIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue, San Rafael, CA 94901 03130/2021 Thomas Collins X❑IND Otticer 1.3. 30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1570 Fifth Avenue, San Rafael. rA 94901 "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$ 84.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. / from 01/01/2021 F 41 of 202 through 06/30/2021 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 TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Thomas Collins X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Thomas Collins RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Thomas Collins RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q Fifth Avenue. ❑ SCC 05/31/2021 Thomas Collins El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Thomas Collins QIND Officer 1_i.SU 102. 10 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenjje. 5an Rafaal- CA 94901 ❑ SCC SUBTOTAL$ 66.50 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 1 � from 01/01/2021 • through 06/30/2021 Page 42 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) REQUIRED) (IF EQUIRED ) OF BUSINESS) 06 F3012021 Thomas Collins X❑IND lOfficer 1.3.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021 Ronda Cordero El IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 Ronda Cordero x❑IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. n Rafael, r.A 94901 ❑ SCC 02/12/2021 Ronda Cordero El IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael, CA 94901 ^ 72126/2021 Ronda Cordero RIND Sergeant li• 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenng, San Rafael, CA qJ901 ❑ SCC SUBTOTAL$ 84.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . , to whole dollars. 1 t from 01/01/2021 • through 06/30/2021 page 43 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 03/15/2021 Ronda Cordero QIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/30/2021 Ronda Cordero X❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth Aypni— San CA 949Q1 ❑ SCC 04/15/2021 Ronda Cordero QIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue. San Rafael. CA 94901 04/30/2021 Ronda Cordero x❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 —55/15/2021 Ronda Cordero RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafae a CA 9AjD_L_ ❑ 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$ 71.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. I ' from 01/01/2021 • through 06/30/2021 Page 44 of 202 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 RECEIVED HIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID.NUMBER) CODE * OCCUPATIONAND SELF-EMPLOYED, EMPLOYER (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 05/31/2021 Ronda Cordero x❑IND Sergeant 13.30 !82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 06/151.2621 Ronda Cordero El IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through- ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/30/2021 Ronda Cordero QIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue - 01/15/2021 Guy Crow RIND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael, CA 94901 — 01/31/2021 Guy Crow RIND Communications Dispatcher ls.yu 14Z..JU C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,1520 Pifth Avenue. San Rafael. CA ❑ 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$ 67.70 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 1 60 from 01/01/2021 O through- 06/30/2021 Page 95 of 202 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 OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID.NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN- 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02./12/2021 Guy Crow RIND Communications Dispatcher 13.90 I-12.3: C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/26/2021 Guy Crow MIND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenu�- q— CA q/1901 [-]SCC 03/15/2021 Guy Crow ©IND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 [-]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0 Fifth Avenue. San Rafap-1. CA 94aa 03/30/2021 Guy Crow X❑IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 74/15/2021 Guy Crow [g]IND Communications Dispatcher 10.40 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ay,;I,, San Rafael. A "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$ 62.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 SCHEDULE A (CONT.) *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov through 06/30/2021 Page 96 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Guy CrowX❑IND Communications Dispatcher 10.40 147.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue.n Rafael -CA 94901 05/15/2021 Guy Crow X❑IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, li2n Fifth AvQn�e. San RaLaRl_ CA 94901 ❑ SCC - 05/31/2021 Guy Crow El IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 FifL12 Avenue 0 06/15/2021 Guy Crow E] IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 I Guy row X❑IND Communications Dispatcher 10.40 14 . C/o: San Rafael Police Association 1520 FifthE] City Of San Rafael COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, Fifth Avenue, 5an Rafael, CA 942QI ❑ SCC _U20 SUBTOTAL$ 52.00 *Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC - Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. 1 ' from 01/01/2021 • through 06/30/2021 Page 47 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO I.D.N OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Heinrich Cuddy []IND Police Officer 17.80 182.i.Ii C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through I intermediary: San Rafael Police Association, -]PTY ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/31/2021 Heinrich Cuddy R] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,El SCC 02/12/2021 Heinrich Cuddy El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Avenue. San RafaQ1. CA 94901 ❑ SCC 02/26/2021 -Fifth Heinrich Cuddy EIIND Police Officer 17.80 le2.10 C/o: San Rafael Police Association 1520 Fifth COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 —D3/15/2021 1 Heinrich Cuddy El IND Police Officer ii.90 192.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 11520 Fifth Ayenup. San Rafa-1 CA 94901 El 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.ne[file.com SUBTOTAL$ 89.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. � � from 01/01/2021 FORM NAME OF FILER San Rafael Police Association Political Action Committee through 06/30/2021 I Page 48 of 202 I.D. NUMBER 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$ 66.501 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov 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) EIIND OF BUSINESS) 03/30/2421 Heinrich Cuddy Police Officer 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Av e San Rafael A 94901 04/15/2021 Heinrich Cuddy El Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue !] OTH San Rafael, CA 94901 Union member's dues received through `1PTY intermediary: San Rafael Police Association, JR20 Fifth AvQnup- San Ra�ael_ CA 94901 J SCC 04/30/2021 Heinrich Cuddy xIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 JL-Ifth Avenue, San Rafael, A 91901 — 05/15/2021 Heinrich Cuddy RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94905 -75/31/2021 Heinrich u yX❑IND Police Officer 13.30 182,10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Av2nme. San Rafael. gA 94 901 ❑ 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$ 66.501 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1 ` from 01/01/2021 O through 06/30/2021 Page 49 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE I.D. (E COMMITTEE, ALSOENTER N * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Heinrich Cuddy MIND Police Officer 13.30 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth avenue. San Rafael CA 94901 06/30/2021 Heinrich Cuddy RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, P [:]SCC 01/15/2021 Casey DeBolt IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth E]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through E]PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. ❑ SCC 01/31/2021 Casey DeBolt X❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 FiEth Avenue, San Rafael CA 94901 QZIIZIZ021 Casey DeBolt MIND Police Otficer li.au 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1 520 Fif [:]SCC SUBTOTAL$ 80.00 'Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period - CALIFORNIA to whole dollars. I 1 from . 01/01/2021 • through 06/30/2021 Page 50 of 2O2 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26 7.021 Casey DeSoitX❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael., CA 94901 03/15/2021 Casey DeBolt X❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Casey DeBolt X❑IND Police Officer '13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth AvgnMe. can Rafael. CA 949QI 04/15/2021 Casey DeBolt E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 I Casey DeBolt X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth '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$ 75.50 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) i/15/2021 Casey DeBoltx IND Police Officer C/o: San Rafael Police Association 1520 Fifth ❑ City Of San Rafael '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 Police Officer amity Of San Rafael lice Officer ty Of San Rafael lice Officer ty Of San Rafael Call Taker & Recor Specialist City of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 page 51 Of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) 13.30 182-10 13.301 lux. 13.301 182.10 13.301 182.10 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue., S 1 CA 94901 05/31/2021 Casey DeBolt E] IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ayeriup, San Rafael- CA 94901 ❑ SCC 06/15/2021 Casey DeBolt x❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 5 CA 94901 06/30/2021 Casey DeBolt E] IND C/o: San Rafael Police Association 1520 Fifth F] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 01115/2021 Re ecca DeLaTorre [91 IND c/o San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, www .._ c�� .____.._ e•__ n, r_�K rn crani ❑ 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 Police Officer amity Of San Rafael lice Officer ty Of San Rafael lice Officer ty Of San Rafael Call Taker & Recor Specialist City of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 page 51 Of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) 13.30 182-10 13.301 lux. 13.301 182.10 13.301 182.10 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. L, from 01/01/2021 FORM through 06/30/2021 Page 52 of 202 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 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO I.D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/311207,1 Rebecca DeLaTorre QIND Call Taker & Records 13.90 142.3.0 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received -through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenug, San Rafael CA 94901 - 02/1212021 Rebecca DeLaTorre x❑IND Call Taker & Records 13.90 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through [IPTY intermediary: San Rafael Police Association, 1520 Fifth Avenue c;Ap RAf�pl CA 94901 [-]SCC 02/26/2021 Rebecca DeLaTorre x❑IND Call Taker & Records 13.90 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth AvpELUe, San Rafael. CA 94901 03/1512021 Rebecca DeLaTorrex❑IND Call Taker & Records 13.90 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Re ecca DeLaTorre 91 IND Call Taker & Records 10.40 19, c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avemia. San Rafael. CA 94901 ❑ SCC SUBTOTAL$ 66.00 *Contributor Codes IND—individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER cam.. PoF�ol D.,1 accr,r��finn Pnlitiral Artinn CnmmittPP Amounts may be rounded to whole dollars. Statement covers period from- 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 53 of 202 I.D. NUMBER 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE NDI.D.N DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Rebecca DeLaTorre X❑IND Call Taker & Records 10.401 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through E]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Rebecca DeLaTorre MIND Call Taker & Records 10.40 1,12.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through E]PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Rebecca DeLaTorreMIND Call Taker & Records 10.40 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Rebecca DeLaTorre MIND Call Taker & Records 10.90 192.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 --66/15/2021 Rebecca UeLaTarre MIND Cali Taxer & Records 1U.40 142.301 C/o San Rafael Police Association 1520 Fifth [:]COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1Fifth — SUBTOTAL$ 52.00 "Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. 1 ' from- 01/01/2021 • " through- 06/30/2021 Page 54 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/34/2021 Rebecca DeLaTorre X❑IND Call Taker & Records 10.40 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021. Blake Delzell RIND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ElPTY intermediary: San Rafael Police Association, 1S20 Fifth &yPnup, San Rafa�l_ CA 24901- ❑ SCC 01/31/2021 Blake Delzell BIND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. Sari Rafael- CA 0 02/12/2021 Blake Delzell ]IND Police Corporal 17.80 162.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 02126/2021 -Blake De ze x❑IND Police corporal 1/.tfU .1 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael. CA 9j9kL ❑ SCC SUBTOTAL $ 81.60 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Mnnatary r_nnfrihiftinns Par-pivprl SCHEDULE A (CONT) Amounts may be rounded Statement covers period towhole o ars. � from 01/01/2021 • ` through 06/30/2021 page 55 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER I AMOUNT CUMULATIVE TO DATE PER ELECTION DATE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Blake Delzell M IND Police Corporal 1-/.8U 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through []PTY intermediary: San Rafael Police Association, ❑ SCC 15.20 Fifth Avenue San Rafael. CA 949.01 73/30/2021 Blake Delzell MIND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue [_]OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aueni— San RA�agl CA 94901 [-]SCC 04/15/2021 - Blake Delzell ❑MIND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue [1 OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1S20 Fifthv n a 4901 04/30/2021 _ Blake Delzell ]IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 5 Blake De ze M❑ IND Police Corporal 13. JU 182.iD C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 15211 Fifth Avenge. 5an Rafael. CA 94901 ❑ 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.neffile.com SUBTOTAL$ 71.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period• . to whole dollars. 11 1 from 01/01/2021 • through 06/30/2021 Page 56 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO .D.N OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/2021 Blake Delzell X❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San FAfa 1 CA 94901 06/15/2021 Blake Delzell RIND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑]PTY intermediary: San Rafael Police Association, 1r9Q Fifth Avoniip, -qan Rafael. Ca 94901 ❑ SCC 06/3012021 Blake Delzell ®IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Bafael. CA n 01/15/2021 Justin Dodson x❑IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, lJ SCC 1520 Fifth Avenue San Rafael CA 94901 01/31/2021 Justin Dodson RIND Police Corporal 17.80 _ 82.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1 520 F,Fth Avenue, San Rafael. CA 9490L ❑ SCC I SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. I � , from 01/01/2021 • through 06/30/2021 Page 57 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 02/12/2D21 Justin DodsonX❑IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/26/2021 Justin Dodson RIND Police Corporal 1%.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/15/2021 Justin Dodson x❑IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [3Com City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. S n CA 94201 ❑ SCC 03/30/2021 -RaLfael. Justin Dodsonx❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue, Sart Rafael, CA 94901 Justin Dodson RIND Police Corporal is.� 1ki2.lU C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, LU20 Fifth Avenue. San ❑ 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$ 80.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1 , from 01/01/2021 O page 58 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30 2021 Justin Dodson X❑IND Police Corporal 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/15/2021 Justin Dodson El IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1_S2Q Fifth Aygnu­ ]3afaP_1_ CA 94901 ❑ SCC 05/31/2021 .9,n Justin Dodson x❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, JS�Q Fifth Avenue, San R�fael. CA 94901 ❑ SCC 06/15/2021 Justin Dodson a] IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM (ity Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Justin DodsonRIND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 66.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. J from 01/01/2021 • through 06/30/2021 Page 59 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSOENTERI.D NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/1512021 .lames DooleyX❑IND Police Corporal 17.80 C/o: San Rafael Police Association 1520 Fifth F] COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/31/2021 James Dooley OIND Police Corporal 1 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through []PTY intermediary: San Rafael Police Association, ❑ SCC 02/12/2021 James Dooley BIND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 02/26/2021 James Dooley RIND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 03115/2D21 James Dooley [91 IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Eifth AyanWe. San Rafael, CA 949n ❑ SCC SUBTOTAL$ 89.00 *Contributor Codes IND- Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULEA Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. i from 01/01/2021 • through 06/30/2021 NAME OF FILER Page 60 of 202 I.D. NUMBER 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$ 66.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 03/30/2021 James Dooley X❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 24901 4/1512021 James Dooley X❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152n PiEth Av6nui-, Ran Rafapl- VA 94.91)1 [:]SCC 04/30/2021 James DooleyX❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth &yenue. San Rafael, QA 94901 ❑ SCC 05/15/2021 James Dooley E] IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Police Corpora 13.30 0 05 1 James Dian ey X]IND C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San R&fael, CA 94901 ❑ 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$ 66.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I � ' from 01/01/2021 • ' through 06/30/2021 Page 61 of 202 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 AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE YEAR 7 PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06115/2021 James DooleyX❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael CA 94901 06/30/2021 James Dooley El IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through 0 PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue- qAn Rafapi CA qA901 ❑ SCC 01/15/2021 Christopher Duncan x❑IND Police Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through F]PTY intermediary: San Rafael Police Association, 1520 Fifth Avgaup, San Rafael. CA 94901 ❑ SCC 01/31/2021 Christopher Duncan El IND Police Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ''ity of San Rafael El COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 1 riston er Duncan [g] IND Police Sergeant 17.80 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC _ SUBTOTAL$ 80.00 'Contributor Codes IND- Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity; PTY -Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A Statement covers period from- 01/01/2921 through 06/30/2021 Page 62 of 202 I.D. NUMBER 831553 SUBTOTAL$ *Contributor Codes 1 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 75.50 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 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) 02/26/2021 Christopher DuncanX❑IND Police Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCG 1520 Fifth Avenue San Rafael CA 94901 03/15/2021 Christopher Duncan [91 IND Police Sergeant 17.80 1$2.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Christopher Duncan X❑IND Police Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 1520 FifLh v ❑ SCC 04/15/2021 Christopher Duncan X❑IND Police Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 99901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 --04/30/2021 Christopher Duncan RIND Poiice sergeant 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, [:] SCC 3520 ri€th Avenue. San Rafael. CA 94901 SUBTOTAL$ *Contributor Codes 1 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 75.50 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period a _ to whole dollars. from 01/01/2021 • through 06/30/2021 Page 63 of 202 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 OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION 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) 45115. 2021 Christopher DuncanX❑IND Police Sergeant 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 — 05/31/2021 Christopher Duncan RIND Police Sergeant 13.30 18?.il C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1r 94gol ❑ SCC 06/15/2021 Christopher Duncan ❑IND Police Sergeant 13.30 ° C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Rafael,lrZO Fifth Avenue, San CA 94901 06/30/2021 Christopher Duncan El IND Police Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 71/15/2021 Kevin Finerty El IND Police Officer 1,1.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC 1520 Fifth '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$ 71.00 , FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period a . to whole dollars. ,I from 01/01/2021 through 06/30/2021 page 64 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Kevin Finerty x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ 0TH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San CA 94901 02112Z2021 Kevin FinertyX❑IND Police Officer 17.801 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City. Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Ay,n,jp- San Raf,pl, CA 94901 ❑ SCC 02/26/2021 Kevin Finerty xIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ayenue. Sari Rafael. CA 24901 03/15/2021 Kevin Finerty F] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 03/30/2021 Kevin Finerty X❑IND Po ice 0111cer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ 0TH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. ❑ SCC SUBTOTAL$ 84.5 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 65 of 202 831553 DATE NDI.D.N DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Kevin Finerty x❑IND Police Officer 13.30 -.-• .• C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael.. CA 94901 04/30/2021 Kevin Finerty 91IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 15211 Fifth Ayenu�_ aan 13�fanl- QA 94901 ❑ SCC 05/15/2021 Kevin Finerty QIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1,520 Fifth Avenue. 01 05/31/2021 Kevin Finerty El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 _ Kevin Finerty 1IND Police Officer 13.30 192. C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth 1 SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period. to whole dollars. from 01/01/2021 M ' through 06/30/2021 page 66 of 202 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 RECEIVED REC CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE * TION AND O(IFSEPAEMPLOYED,ENTER NAAMER PER (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 06/30/2021 Kevin Finertyx❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael, CA 94901 01./15/2021 Jenna Fisher [91 IND Communications Dispatcher 13.90 142.30 c/o San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 01/31/2021 Jenna Fisher X❑IND Communications Dispatcher 13.90 142.30 c/o San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Aven01 02/12/2021 Jenna Fisher X❑IND Communications Dispatcher 13.90 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael, CA 94901 20 1 Jenna Fisher X❑IND Communications Dispatcher 13.90 142.30 c/o San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 2 "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$ 68.90 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTERI.D.NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 415/2421 Jenna FisherX❑IND Communications Dispatche c/o San Rafael Police Association 1520 Fifth City of San Rafael "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 Communications Dispatcher City of San Rafael SCHEDULE A (CONT.) Statement covers period CALIFORNIA from 01/01/2021 FORM through 06/30/2021 Page 67 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN. 1 - DEC. 31) 13.90 142.-�i 10.40 142..3( mmunications Dispatcher 10.40 142.30 ty of San Rafael mmunications Dispatcher) 10.401 142.30 ty of San Rafael ` mmunications Dispa ty of San Rafael SUBTOTAL$ 55.50 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 51/30/2021 Jenna FisherX❑IND c/o San Rafael Police Association 1520 Fifth ❑ COM Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/15/2021 Jenna Fisher x❑IND c/o San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through F-1PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael, CA 24qOJ 04/30/2021 Jenna Fisher R] IND c/o San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 05/15/2021 Jenna Fis er X❑ IND c/o San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY mediary: San Rafael Police Association, intermediary: .._ 1 . r__ —1— rw enen ._.__.__ 1 F1 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 Communications Dispatcher City of San Rafael SCHEDULE A (CONT.) Statement covers period CALIFORNIA from 01/01/2021 FORM through 06/30/2021 Page 67 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN. 1 - DEC. 31) 13.90 142.-�i 10.40 142..3( mmunications Dispatcher 10.40 142.30 ty of San Rafael mmunications Dispatcher) 10.401 142.30 ty of San Rafael ` mmunications Dispa ty of San Rafael SUBTOTAL$ 55.50 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I , from 01/01/2021 • through -06/30/2021 Page 68 of 202 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 OCCUPATIONEMPLOYER AMOUNT RECEIVEDP CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IFCOMMITEE,ALSO ENTER I.D.NUMBER) CODE * p UPFA-TIO SELF-EMPLOYED, DTHIS (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 05/31/2021 Jenna Fisher X❑IND Communications Dispatcher 10.40 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 06/15/2021 Jenna Fisher X❑IND Communications Dispatcher 10.40 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 52a Fiftb Aven— San Rafap.1- CZ 94901 ❑ SCC 06/30/2021 Jenna Fisher E] IND Communications Dispatcher 10.40 142.30 c/o San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue, San Rafael, CA 94901 01/15/2021 Danielle Fry RIND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 99901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/31/2021 Danielle Fry RIND Call Taker/Records 13.9u 142-30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 15213 Fiftb AveLl3je. San Rafael. CA 21201 ❑ SCC SUBTOTAL$ 59.00 'Contributor Codes IND–Individual COM – Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY–Political Party SCC–Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. � * ' from 01/01/2021 • through 06/30/2021 Page 69 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Danielle FryX❑IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152 Fifth Avenue San Rafael CA 94901 02/26/2021 Danielle Fry 91 IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1S20 Fifth Av�n�e. San RafApl- CA 94901 ❑ SCC 03/15/2021 Danielle Fry X❑IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth []COM Specialist Avenue ❑ OTH City Of San Rafael San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Q F!fLh Avenue. 94903- 03/30/2021 Danielle Fry MIND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 4 Danielle fry 91 IND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]Com Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, n S�4101 E] SCC SUBTOTAL$ 62.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. E i from 01/01/2021 through 06/30/2021 page 70 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE 7RRECE71VED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) IF REQUIRED ( ) OF BUSINESS) 04/3QDanielle FryX❑IND Call Taker/Records 10.40 ).'..'•:' C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenu San Rafael CA 94901 05/15/2021 Danielle Fry MIND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth El COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aveni— SAn Rafapl. CA C)4901 ❑ SCC 05/31/2021 Danielle Fry MIND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 0Avenue. ❑ SCC MIND 06/15/2021 Danielle Fry Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 716/30f2021 Danielle FryMINDCall Taker/Records 1U.4U 14 . 77 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 52.00 *Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period U . , to whole dollars. ■ ' from 01/01/2021 through 06/30/2021 page 71 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ND ZIP FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT , RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) IF CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Oi,iJ12021 Anna FulgadoX❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01 31/2021 Anna Fulgado RIND Dispatcher 13.90 .147..30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1S20 Fifth Aupni— qAn RAfapl_ CA 94C)01 [:]SCC 02/12/2021 Anna Fulgado RIND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, q4qnj 1520 Fifth Avenue, San Rafae . QA ❑ SCC 02/26/2021 Anna Fulgado X❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 —03/15/2021 Anna Fulgado [X] IND Dispatcher 142.30 San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 69.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. ' from - 01/01/2021 � NAME OF FILER San Rafael Police Association Political Action Committee FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) S/3012021 Anna Fulgado MIND Dispatcher C/o: San Rafael Police Association 1520 Fifth City Of San Rafael '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 Dispatcher City Of San Rafael Dispatcher City Of San Rafael spatcher ty Of San Rafael spatcner ty Of San Rafael through= 06/30/2021 I Page 72 of 202 Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 2O Fifth Avenue Sacs Rafael CA 94901 ❑ COM ❑ OTH ❑ PTY ❑ SCC 04/15/2021 Anna Fulgado MIND CALENDAR YEAR C/o: San Rafael Police Association 1520 Fifth ❑ COM (JAN. 1 - DEC. 31) Avenue ❑ OTH 142.30 San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/30/2021 Anna Fulgado MIND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1 20 Fifth Avenue. San aafael, CA q4901 05/15/2021 Anna Fulgado MIND C/o: San Rafael Police Association 1520 Fifth F-1COMAvenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 1 Anna Fulgado MIND C/o: San Rafael Police Association 1520 Fifth F] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, aA&A] F_1SCC '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 Dispatcher City Of San Rafael Dispatcher City Of San Rafael spatcher ty Of San Rafael spatcner ty Of San Rafael through= 06/30/2021 I Page 72 of 202 10.401 19z. 10.401 142.30 10.401 142.30 SUBTOTAL$ 52.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10.90 142.30 10.401 19z. 10.401 142.30 10.401 142.30 SUBTOTAL$ 52.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 73 of 202 I.D. NUMBER 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Ti 06/15/2421 Anna Fulgado X❑IND Dispatcher 10.40 ?.3 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue San Rafael CA 94901 06/30/2021 Anna Fulgadox❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/15/2021 Christopher Fuller x❑IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avemie. San RafaQ1, CA 94901. 01/31/2021 Christopher Fuller E] IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 Christopher Fuller X❑IND Corporal 82.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifl:h Avenue- San Rafagj. CA 94901 ❑ SCC 1 SUBTOTAL$ 74.20 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I , from 01/01/2021 • " through. 06/30/2021 Page 74 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ND O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26/2021 Christopher Fuller [xfIND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: SanRafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03115/2621 Christopher Fuller x❑IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Christopher Fuller El IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v l. CA 94901 04/15/2021 Christopher Fuller E] IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue, San Rafael, CA 94901 --54130/2021 Christopher Fu er x❑IND Corporal 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Raf.&ej. CA 94901 [:]SCC SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from: 01/01/2021 FORM through 06/30/2021 Page 75 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/202.1 Christopher Fuller FK] IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 520 Fifth Avenue San Rafael CA 94901 05/31/2021 1 Christopher Fuller KIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Christopher Fuller x❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue.n Rafael. 06/30/2021 Christopher Fuller X❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael, CA 94901 Salvatore Uaranzxni [g] IND officer o 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL $ 71.00 *Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity; PTY -Political Party SCC - Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period , _ to whole dollars. ■ a I from- 01/01/2021 �' through- 06/30/2021 page 76 of 202 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 ND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Salvatore GaranziniX❑IND Officer 17.80 1.82.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 RIND - 02/12/202.1 Salvatore Garanzini otticer 17.80 182..10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Salvatore Garanzini ®IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through E]PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue. San RafAP1. CA 94201 03/15/2021 Salvatore Garanzini x❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue, San Rafael CA 94901 03/30fzQzl Salvatore Garanzini X❑IND Officer li. u 1 2.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC 1520 Fifth Avenl1a. San RafAP1_ CA c)4901 "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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. ■ 601 from 01/01/2021 • through 06/30/2021 Page 77 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE,ALSO ENTER I D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME + PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Salvatore Garanzini El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael 94901 04/34/2021 Salvatore Garanzini [X]IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q F�fth Avgnug. San Rafael- CA 949Q1 ❑ SCC 05/1512021 Salvatore Garanzini El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Salvatore Garanzini E] IND Officer 13.30 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Salvatore Garanzini X❑IND Officer 13. 2.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth Avenue. San RafApal. CA 94901 ❑ SCC .1520 SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. � � from 01/01/2021 FORM through 06/30/2021 Page 78 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIPO CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE (E COMMITTEE, ALSO I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/3072_ 1 Salvatore Garanzini X❑IND Officer 13.3U C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 9490 01/15/2021 Justin Graham [g] IND Sergeant 17.80 182.).0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 Justin Graham 21IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue. n Rafael- 02/12/2021 Justin Graham F1 IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 FJOTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 —6212612921 Justin Gra am MIND Sergeant 17.80 182.101 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1590 Fifth Avenue. San Bafae1___CA__2L2_Q1_- ❑ SCC 1 SUBTOTAL$ 84.50 "Contributor Codes IND—Individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC—Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 1115/2021 Justin Graham[X]IND Sergeant C/o: San Rafael Police Association 1520 Fifth ICity of San Rafael SUBTOTAL$ *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.neffile.com SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 79 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 17.80 182.1❑ 13.30 13.30 71.00 .1 182.10 182.10 1 .1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑COM San Rafael, CA 94901 ❑ OTH Union member's dues received through FIFTY intermediary: San Rafael Police Association, ❑ SCC 520 Fifth Avenue San Rafael, CA 94901 03/30/2021 Justin Graham x❑IND Sergeant C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [] PTY intermediary: San Rafael Police Association, IS20 Ei;Cth AVPnup- San Rafael, Cb, 949 [:]SCC 04/15/2021 -OL Justin Graham ©IND Sergeant C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through []PTY intermediary: San Rafael Police Association, 15�Q Fifth Avenue. San Rafael. CA 94901 ❑ SCC 04/30/2021 Justin Graham RIND Sergeant C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Justin Gra am RIND Sergeant C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police. Association, ❑ SCC SUBTOTAL$ *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.neffile.com SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 79 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 17.80 182.1❑ 13.30 13.30 71.00 .1 182.10 182.10 1 .1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Qo T?ofn l Pnli— Acc i ati— Pnliti — I Artinn Cnmmittpp Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 I Page I.D. N 831553 SCHEDULE A (CONT.) 80 of 202 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUM ULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Sergeant 13.30 05/31/2021 Justin Graham X❑IND 382.70 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue San Rafael CA 94901 -- 06/15/2421 Justin Graham x❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM "ity of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 06/30/2021 Justin Graham x❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. S,n RafaelCA 94901 ❑ SCC 01/15/2021 Christopher R Heinlein X❑IND Police Officer 13.90 178.20 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 99901 01731/2021 ristop er R KOan e n X❑IND Police Officer 1/.SSU 1 U C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police A2520 Fifth Avenue. San Rafael, CAssociation, _ G ❑ SCC SUBTOTAL$ 71.60 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period =CALIFORNIA to whole dollars. ` from 01/01/2021 FORM NAM E O F FI LER San Rafael Police Association Political Action Committee FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 02/12/2021 Chr stopher R Heint.ei.n X❑IND Police Officer C/o: San Rafael Police Association 1520 Fifth City Of San Rafael *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 ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC Police Officer City Of San Rafael Police Officer City Of San Rafael lice Officer ty Of San Rafael ty Of San Rafael SUBTOTAL$ through 06/30/2021 AMOUNT RECEIVED THIS PERIOD 17.80 17.80 17.80 13.30 Iff 80.00 Page 81 of 202 I.D. NUMBER 831553 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) 1.20 178.70 178.20 178.20 179.20 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 520 Fifth Avenue San Rafael CA 94901 02/26/2021 Christopher R Heinlein C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ('.A q4q01 03/15/2021 Fi fth Avenue San Rafael- Christopher R Heinlein C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 94901 03/30/2021 Christopher R Heinlein C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 134115/2021Christopher R ezn ezg C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, *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 ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC Police Officer City Of San Rafael Police Officer City Of San Rafael lice Officer ty Of San Rafael ty Of San Rafael SUBTOTAL$ through 06/30/2021 AMOUNT RECEIVED THIS PERIOD 17.80 17.80 17.80 13.30 Iff 80.00 Page 81 of 202 I.D. NUMBER 831553 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) 1.20 178.70 178.20 178.20 179.20 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period o . , to whole dollars. I O D from 01/01/2021 • through: 06/30/2021 Page 82 of 202 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 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 13.30 01,/30/2021 Christopher R Heinlein MIND Police Officer C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152.0.Fifth Avenue San Rafae A 94901 05/15/2021 Christopher R Heinlein RIND Police Officer 13.30 178..20 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Christopher R Heinlein MIND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Rafael, CA 94901 is2n Fifth Aveklup. S 06/15/2021 -an Christopher R Heinlein MIND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM amity Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Christopher R Heinlein X❑IND Police Otticer 1.5.1U S •�J C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,_L520 Fifth Avenue. ElSCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period�. , to whole dollars. * , from 01/01/2021 through 06/30/2021 page 83 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER { AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I-D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Lori Hendricks x❑IND Dispatcher 13.90 142.36 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fift Avenue San Rafael 94901 01/31/2021 Lori Hendricks E] IND Dispatcher 13.90 142.30 C/O: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 02/12/2021 Lori Hendricks El IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1S20 Fifth LyQaup. San R,2fael. QA 1 02/26/2021 Lori Hendricks IND Dispatcher R 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 —03/15/2021 Lori Hendricks X❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC 15�0 Fifth Avexiue. San Rafael, A 9 SUBTOTAL$ 69.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. I , from 01/01/2021 • through 06/30/2021 Page 84 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/30/2021 Lori Hendricks x❑IND Dispatcher 10.40 142..3U C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue Son Rafael CA 94901 04/15/2421 Lori Hendricks El IND Dispatcher 10.40 141.39 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/30/2021 Lori Hendricks QIND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenug. n A 94901 05/15/2021 Lori Hendricks X❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 1 3 Lots Hendricks QIND Dispatcher lU.40 142.30 C/o: San Rafael Police Association 1520 Fifth COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafael.1520 Fifth Avenue. San ❑ SCC SUBTOTAL$ 52.00 "Contributor Codes IND -individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC - Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. ■ from 01/01/2021 Page 85 of 202 through 06/30/2021 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 ND O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO I.D. NUMBER CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Lori Hendricks QIND Dispatcher 10.90 192.30 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 06/30/2021 Lori Hendricks x❑IND Dispatcher 10.40 197.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/15/2021 Robert Henkle El IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Ziftb Avenue. Sari Rafael . ('.A q4901 ❑ SCC 01/31/2021 Robert Henkle QIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 99901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 99901 0zlizinzi Ro rt Henk aMINDUtticer 1/.80 182.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael. CA 949G ❑ SCC I -L— SUBTOTAL$ 74.20 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. # from 01/01/2021 FORM through 06/30/2021 page 86 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (E COMMITTEE, ALSO I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 2672Robert Henkle X❑IND Officer 1%.80 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/15/2021 Robert Henkle X❑IND Officer 17.80 ]82.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Fifth Aypni— Sqn P-afaP.1 CA q4901 ❑ SCC 03/30/2021 Robert Henkle El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifjh Ayenue. San RafaQ1, 04/15/2021 Robert Henkle E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 74J30/2021 Ro ert Henkle E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth - SUBTOTAL$ 75.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period _ to whole dollars. / 1 from 01/01/2021 a through 0 6/30 /2021 Page 87 of 202 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 O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR NDI.D. CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Robert HenkleX❑IND Officer 13.30 ='-l0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue n Rafael CA 94901 _ 05/31/2021 Robert Henkle 91 IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Robert Henkle rjjIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, 06/30/2021 Robert Henkle E]IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 __01/15/2021 Ryall Fi rsC nitz El IND Police Officer i i . uu 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael El COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth-AyRnue. San Rafael, CA 94991 ❑ SCC SUBTOTAL$ 71.00 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from 01/01/2021 • through 06/30/2021 Page 88 Of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (E COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01./31/ 021 Ryan Hirschnitz El IND Police Officer 17.80 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue n R fael CA 94901 _ 02/12/2021 Ryan Hirschnitz XIND Police Officer 17.80 182.1ii C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Av�ni­ Snn Rafael. CA 94901 ❑ SCC 02/26/2021 Ryan Hirschnitz EIIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth v Rafael. 03/15/2021 Ryan Hirschnitz R] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC _TTT3_07T0_ff11-- 1520 Fifth Avenue San Rafael CA 94941 182.10 Ryan Hirschnitz E] IND Police Officer ls.3u C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San–Rafael. CA 949QI— ❑ SCC I '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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may rounded Statement covers period CALIFORNIA lars. to whole dollars. 460 from 01/01/2021 • through 06/30/2021 Page 89 of 202 NAMEOF FILER I.D. NUMBER San Rafael Police Association Political Action Committ 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ND CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Ryan Hirschnitz RIND Police Officer 13.30 C/o: San Rafael Police Association 1520 Fifth COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Ryan Hirschnitzx❑IND Police Officer 13.30 182.1.'. C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 110n Fifth AvPntjP._ Rafagl, CA 9:4901 ❑ SCC 05/15/2021 -qan Ryan Hirschnitz MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [] SCC 1520 Fiftb Avenue. San Rafael. CA 94901 05/31/2021 Ryan Hirschnitz MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 D15/15/2022. Ryan Hirschnitz El IND Police Officer C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avprlue, San RafLe_j_ CA q4901 ❑ 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$ 66.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1 60 from 01/01/2021 O' through 06/30/2021 page 90 of 202 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 TO DATE DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/7.07.1 Ryan Hirschnitz X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021 J. Alexander Holm E] IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 J. Alexander Holm RIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael90 02/12/207.1 J. Alexander Holm El IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 -7272612021 J. Alexander oto [g] IND Sergeant 11.00 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue- San qafael. CA 91901 ❑ 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.nefile.com SUBTOTAL$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. ■ � from 01/01/2021 ` through 06/30/2021 Page 91 of 202 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 RECEIVED THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 J. Alexander Holmx❑IND Sergeant 17.60 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520.FiLU Avenue San Raf el CA 94901 03/30/2021 J. Alexander Holm X❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue [_]OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS2a Fifth Ay�_nup, San Rafael- CA q4901 ❑ SCC 04/15/2021 J. Alexander Holm ®IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Avenue. ❑ SCC 04/30/2021 . Alexander Holm X❑IND Sergeant 13.30 182.10 /o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael [Avenue an Rafael, CA 94901 E]OTH nion member'sdues received through ❑ PTY ntermediary: San Rafael Police Association, ❑SCC 520 Fifth Avenue, San Rafael, CA 94901 05115/2021 J. A exan er Holm RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 949_01 SCC SUBTOTAL$ 71.00 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC—Small Contributor Committee www.nefile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. , from 01/01/2021 " through 06/30/2021 Page 92 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/2021 J. Alexander Holm ❑KIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, A 94901 06/15/2021 J. Alexander Holm x❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/30/2021 J. Alexander Holm RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 El OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. Sari Rafoel. CA 9 9 01/15/2021 Carl Huber X❑IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Carl Huber X❑IND Sergeant 17.130 182,10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 rLifth Avenue, San Rajagj, CA 94901 ❑ SCC SUBTOTAL$ 75.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 SCHEDULE A (CONT.) *Contributor Codes 1 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov through 06/30/2021 Page 93 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT OCCUPATION AND EMPLOYER RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02./1212.021 Carl HuberX❑IND Sergeant 1-7.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael, CA 94901 02/26/2021 Carl -Huber MIND _ Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 03/15/2021 Carl Huber �x]IND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue []OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 0 Fifth Avenue. San Rafael, Carl HuberX❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [IPTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael CA 94901 -04/15/2021 Carl Huber MIND Sergeant 1.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Re_Ldal. CA ❑ SCC SUBTOTAL$ 80.00 *Contributor Codes 1 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received .Amounts may be rounded Statement covers period• . , to whole dollars. I ' from 01/01/2021 • ' through 06/30/2021 Page 94 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/207.1 Carl Huber RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, []SCC 20 Fifth Avenue San Rafael CA 94901 05/15/2021 Carl Huber El IND sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1S20 Fifth Avenue- -gan CA 94901 ❑ SCC 05131/2021 Carl Huber RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fjfth Aygnup, San Rafael, CA Q4901 016/15/2021 Carl Huber KJIND Sergeant 13.301 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, U SCC 1520 Fifth Avenue, San Rafael CA 94901 __W30/2021 Carl Huber [g] IND Sergeant l 1B2.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael El COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 66.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received SCHEDULE A (CONT.) Amounts may be rounded Statement covers period w wnanc uvuai a.6 from 01/01/2021 • through 06/30/2021 7Page 95 of 202 NAME OF FILER 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 RECEIVED HIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE TOQUIR RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * O(IFSELPFEMP SELF-EMPLOYED, ETION AND NTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 17.80 01/15/2621 Scott Ingels MIND Sergeant F 1' C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY _ intermediary: San Rafael Police Association, [-]SCC l 1520 Fifth Avenue San Rafael CA 94901 01/31/2021 Scott Ingels MIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1_F20 Fifth Aygnij— San Rafael CA 24201 ❑ SCC 02/12/2021 Scott Ingels MIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 5 v nRafAP.1. CA 94 901 02/26/2021 Scott Ingels MIND Sergeant 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael CA 94901 3 51 Scott Ingels MIND Sergeant 1 92.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, if ❑ SCC SUBTOTAL$ 89.00 "Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . , to whole dollars. I , from 01/01/2021 • through 06/30/2021 Page 96 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR NDI.D.UMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER 1 AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO . CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/30/2021 Scott Ingels RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue San Rafael 94901 04/15/2021 Scott Ingels x❑IND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 11,2C Fifth Aypnug. _qAn RAfapl, CA 94901 ❑ SCC 04/30/2021 Scott Ingels RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth v 99 0 05/15/2021 Scott Ingels RIND Sergeant 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Scott Ingels RIND Sergeant 13.30 1882.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth A_yenue. San CA ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. from 01/01/2021 FORM through 06/30/2021 Page 97 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ 0.6/15/2021 Scott Ingels RIND Sergeant i3.su ].82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑SCC 152.0 Fifth Avenue an Rafael, CA 94901 06.!3012021 Scott Ingels X❑IND Sergeant 13.30 182.].0 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 01/15/2021 Joseph Jordan X IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avenue. San R�­F�pjCA 94901 ❑ SCC 01/31/2021 Joseph Jordan x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue San Rafael, CA 94901 Joseph Jordan x❑IND Police Officer li.uu C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Raf�ual - CA 94901 []SCC SUBTOTAL$ 80.00 "Contributor Codes IND—individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. A i from 01/01/2021 page 98 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR A RE, CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ALSAND (IF COMMITTEE, I.D.N IT CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26/2.02.1 Joseph Jordan MIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/15/2021 Joseph Jordan MIND Police Officer 17.80 182.30 C/O: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafapl. r.A q4gni ❑ SCC 03/30/2021 Joseph Jordan X IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Q Fifth Azenue. San RAfael. CA 94901 04YI5/2021 Joseph Jordan KIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 4 Josep Jordan [91 IND Police Officer li-3i 18 ._ C/o: San Rafael Police Association 1520 Fifth [-] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Ayenui-., 5an Rafael, CA 94q_QL_ []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$ 75.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. I ' from- 01/01/2021 " througfF 06/30/2021 page 99 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER ' AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Joseph Jordanx❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue. San Rafael CA 94901 05%31/2021 Joseph Jordan RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [:]PTY intermediary: San Rafael Police Association, IS2C Fifth Avanue- San Rafael. CA 94C)01 ❑ SCC 06/15%2021 Joseph Jordan X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q Fifth Avenue, ❑ SCC 06/30/2021 Joseph Jordan MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael, CA 94901 1 Cheryl on ati,e MIND Police Officer 1 I. eu 182.1U C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth AygnUe- San RALaPl. C& R4%01-- ❑ 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$ 71.001 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER cam„ Dnlino Accnniatinn Pnliti—i Artinn ('nmmitt- Amounts may be rounded to whole dollars. SCHEDULE A (CONT. Statement covers period from 01/01/2021 through 06/30/2021 page 100 of 202 I.D. NUMBER 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT 1 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Cheryl Kondratieffx❑IND Police Officer 17.80 182.1.0 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/12/2021 Cheryl Kondratieff El IND Police Officer 17.80 182.1.0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, I-Fi9n FifLh Avpniip- San Rafael- CA 94901 ❑ SCC 02/26/2021 Cheryl Kondratieff x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. f 03/15/2021 Cheryl Kondratieff X❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 73130/2021 Cheryl Kondratieff El IND Police Officer 13,30 18 0 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth Avenue- San gafagj, CA 942DJ-- ❑ SCC _U20 SUBTOTAL$ 84.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received SCHEDULE A (CONT.) Amounts may be rounded Statement covers periodl . I , ' to whole dollars. A , from 01/01/2021 through- 06/30/2021 101 of 202 71.DNUMBER NAME OF FILER San Rafael Police Association Political Action Committee 1 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (IF COMMITTEE, ALSO ENTER ID.NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 13.30 l _ 04/15/2021 Cheryl Kondratieff QIND Police Officer 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Cheryl Kondratieff RIND Police Officer 13.30 1d2.IU C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Cheryl Kondratieff El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Figkb Avenue, rA 94901 05/31/2021 Cheryl Kondratieff E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 76/15/2.021 Cheryl Kon ratxe QIND Police Officer i3.30 182.10 C/o: San Rafael Police Association 1520 Fifth COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY. intermediary: San Rafael Police Association, 1520 Fifth Aygnue. San Rafael. CA 9ja0l ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period •. , to whole dollars. I ' from 01/01/2021 • through 06/30/2021 Page 102 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/2021 Cheryl Kondratieff X❑IND Police Officer 13.30 i92.1u C/o: San Rafael Police Association 1520 Fifth[:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through FIFTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 — 01/15/2021 Anndora Lee X❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth A—nii— -gan Raf-1. CA 94901 ❑ SCC 01/31/2021 Anndora Lee ®IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Ayenue. San Rafaej, QA 949nl– 02/12/2021 Anndora Lee X❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Anndora Lee BIND Dispatcher 13.9U i42.3u C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1_1�2D Fifth Avenue- ❑ SCC SUBTOTAL$ 68.90 "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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period _ to whole dollars. 1 ' from 01/01/2021 • " through 06/30/2021 page 103 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Anndora LeeX❑IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [DOTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael .94901 D3/30/2021 Anndora Lee RIND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [3Com City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aypnup- San Rafael. CA 94901 [:]SCC 04/15/2021 Anndora Lee RIND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Auenue. San Rafael. CA 94901 ❑ SCC 04/30/2021 Anndora Lee FX]IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth L] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 —05/15/2021 Ann cra Lee El IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, 5an Rafae-1. CA ❑ SCC SUBTOTAL$ 55.50 "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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period •. , to whole dollars. 1 from 01/01/2021 • ' through 06/30/2021page 104 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (E COMMITTEE, ALSO .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) 45131 2421 Anndora LeeX❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1,520 Fifth Avenue San Rafael CA 94901 06/15/2021 Anndora Lee E] IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1&20 Fifth A—n— San Rafael- CA 94901 ❑ SCC 06/30/2021 Anndora Lee x❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth v n 01/15/2021 Karl Luhmann E] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01131/2021 Karl Luhmann E] IND Police Officer 17.90 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 949QI ❑ SCC SUBTOTAL$ 66.80 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 � , from 01/01/2021 FORM through 06/30/2021 page 105 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Karl Luhmann X❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue Sari Rafael CA 94501 02/26/2021 Karl Luhmann x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Elfth Aypnue. San Rafapl CA 94901 ❑ SCC 03/15/2021 Karl Luhmann ©IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Avenue.1520 Fifth 0 03/39/2021 Karl Luhmann QIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 4 Karl u mann [g] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafagl. CA 949QI-- ❑ SCC SUBTOTAL$ 80.00 "Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity; PTY—Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. ■ , from 01/01/2021 a through 06/30/2021 page 106 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO D NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 0.4/30/2021 Karl LuhmannX❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael 94901 05/15/2021 Karl Luhmann[g]IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafael. [-]SCC 05/31/2021 Karl Luhmann E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Karl Luhmann X❑IND Police Officer 13.30 16$.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Karl Luhmann E]IND Police Otticer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue- El SCC SUBTOTAL$ 66.50 "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 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers periodF to whole dollars. / ' from 01/01/2021 through 06/30/2021 107 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO .D NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 0.1/15/2021 Kevin Macdougald x❑IND Officer 17.80 182,10 C/o: San Rafael Police Association 1520 Fifth [jCOM City of San Rafael Avenue San Rafael, CA 94901 [20TH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, n SCC 152D Fifth Avenue. n Rafael CA 94901 01/31/2021 Kevin Macdougald RIND Officer 17.80 1.82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, IS20 Eigth Aypn­ San Rafael. CA 94901 []SCC 02/12/2021 Kevin Macdougald ®IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC IS20 Fifth AvWaue. San Rafael. CA 94901 02/26/2021 Kevin Macdougald X❑IND fficer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM ity of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 --03/15/2021 Kevin Macdougald X❑IND Officer 17.80 182.1 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth ❑ SCC SUBTOTAL$ 89.00 "Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity; PTY— Political Party SCC—Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. 1 , from 01/01/2021 i through 06/30/2021 Page 108 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID.NUMBER) CODE* OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Q3/3012021 Kevin Macdougaldx❑IND Officer 182.1i? C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Kevin Macdougald 91IND Officer 13.30 C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 1520 Fifth Avenup- San Rafael, CA []SCC 04/30/2021 Kevin Macdougald CIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth 46venue- San Rafael. CA 94Q01 ❑ SCC 05/15/2021 Kevin Macdougald E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM "ity of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 3 Kevin Macdougald E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, Fifth1520 ElSCC SUBTOTAL$ 66.50 *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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 1 f , from 01/01/2021 • ' Page 109 of 202 through 06/30/2021 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 TO DATE DATE (IF COMMITfEE,ALSO ENTER LD NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Kevin Macdougald FA] IND Officer 13.30 1$2.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue San Rafael CA 94901 05/30/2021 Kevin Macdougald RIND Officer 13.30 iG.lO C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 01/15/2021 Kaitlin Maley X❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v n Rafael. CA 94901 01/31/2021 Kaitlin Maley x❑iND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 1 Kaitlin Maley 71IND POlic2 Officer 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue. San RAfapl. CA 942D-1— SUBTOTAL$ 80.00 'Contributor Codes IND–Individual COM – Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY– Political Party SCC – Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period_ to whole dollars. , from 01/01/2021 F through 06/30/2021 110 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE DATE RECEIVED (E COMMIT I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02/26/2021 Kaitlin Maley F_IND Police Officer i%.8U C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 0.3/15/2021 Kaitlin Maley x❑IND Police Officer 1%.80 182.10' C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Ftfth Aypnup- San RALOV1. CA 94901 ❑ SCC 03/30/2021 Kaitlin Maley x IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth AvenuQ, San Rafgpl. CA 94901 04/15/2021 1 Kaitlin Maley El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenueo San Rafael., CA 94901 —'04/30/2021 Kaitlin Maley [g] IND Police officer 13.30 1 82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth A=�e. ❑ 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$ 75.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period _ to whole dollars. 1 from 01/01/2021 i through 06/30/2021 page 111 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (E COMMITTEE, ALSO I.D.N 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) 05/15/2021 Kaitlin Maley x❑IND Police Officer 3.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]Com City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/31/2021 Kaitlin Maley ElIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth Aygn­ San Rafael- CA 94901 ❑ SCC 06/15/2021 Kaitlin Maley El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 5 venue, 94901 06/30/2021 Kaitlin Maley RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ City Of San Rafael COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/15/2021 Lee Masten E] IND Police Orricer 1/.8u 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 ;f (.-& [:]SCC SUBTOTAL$ 71.00 'Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC- Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period I CALIFORNIA to whole dollars. 1 ' from 01/01/2021 O' through 06/30/2021 Page 112 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 41/33/2021 Lee Masten 91 IND Police Officer 17.80 0 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 520 Fifth Avenue San Rafael CA 94901 02/12/2021 Lee Masten EjIND Police Officer 17.80 IRP. -In C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Lee Masten El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1�2p Zifth Ay-enlae. San Rafael, CA 94901 ❑ SCC 03/15/2021 Lee Masten El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael CA 94901 —'6313.0/202 Lee MastenMINDPolice OYficer i3.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth n ❑ SCC SUBTOTAL$ 84.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. 1 from 01/01/2021 � Page 113 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE (E COMMITTEE, ALSO I.D.N * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IFSELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) TTI 5 12 0-2 1 Lee MastenX❑IND Police Officer 13.30 182.-10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Lee Masten MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth Aygn­ San Raf-1- CA q4901 [:]SCC 05/1512021 Lee Masten MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through E] PTY intermediary: San Rafael Police Association, Rafael.1520 Fif-th Amenue. San ❑ SCC 05/31/2021 Lee Masten MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth `'ity Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 06/1512021 Lee Masten MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth ❑ SCC SUBTOTAL$ 66.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . NIA to whole dollars. 1 ' from 01/01/2021 • through 06/30/2021 page 114 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ZIP FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ADDRESS CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06•/3 0 T2021 Lee MastenX❑IND Police Officer 13.30 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1,520 Fifth Avenue San Rafael CA 94901 01/1!i./2021 Michael Mathis X❑IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1c;20 Fifth Aygni2a- San Rafaal. QA 94901 ❑ SCC 01/31/2021 Michael Mathis ®IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [–]Com City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fjftj� Menue—aan Rafael. CA 94901 ❑ SCC 02/12/2021 Michael Mathis RIND Corporal 17.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 02/26/2021 Michael at is KIIND Corporal 1/.0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q Fifth Avenue. San Rafael, CA 94901 ❑ SCC SUBTOTAL$ 84.50 *Contributor Codes IND– Individual COM– Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY–Political Party SCC– Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 115 of 202 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Michael Mathisx❑IND Corporal 17.8u 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 i£th. Avenue San Rafael CA 94901 03/30/2421 Michael Mathis RIND Corporal 1 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Z�ypnup- San Rafagl_ CA 94901 ❑ SCC 04/15/2021 Michael Mathis ®IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1�2Q Fifth Avenue. San Rafael. CA 94901 ❑ SCC 04/30/2021 Michael Mathis RIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 05/15/2021 Michael Mathis RIND Corporal i.s..5U I 82.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 71.00 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. ,[ ` from 01/01/2021 through 06/30/2021 page 116 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ZI DE O NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE 7DATEFULL RE (E COMMITTEE, ALSAND .D,N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 05/Michael Mathis MIND Corporal 1-1.-1U 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police_ Association, ElSCC 1520 Fifth Avenue San Rafael CA 94901 66/15/2021 Michael Mathis MIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Av6nu�_ San RafApl- ('.A 94901 ❑ SCC 06/30/2021 Michael Mathis MIND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through LlPTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 ❑ SCC 01/15/2021 Daisy B Mazariegos MIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Ra€ael CA 94901 113 Daisy B Mazariegos MIND Police Officer ii. !82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 F�fth Av,riue. San RaLa.Lj. CA 94901 ❑ 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$ 75.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 02/12/2021 Daisy B Mazariegos X❑IND Police Officer C/o: San Rafael Police Association 1520 Fifth City Of San Rafael -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 ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC KIND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC lice U111cer ty Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael City Of San Rafael II Statement covers period I from 01/01/2021 SUBTOTAL$ SCHEDULE A (CONT.) through 06/30/2021 page 117 of 202 I.D. NUMBER AMOUNT RECEIVED THIS PERIOD 1 17.80 13. 80.00 831.553 CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 -DEC. 31) Avenue 82.10 San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael A 94901 021?612021 Daisy B Mazariegos C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 152D San Rafael, CA949DI 03/15/2021 Fifth Avenup, Daisy B Mazariegos C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 03/30/2021 Daisy B Mazariegos C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael CA 94901 0 Daisy B Mazariegos C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, -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 ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC KIND ❑ COM ❑ OTH ❑ PTY ❑ SCC x❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC lice U111cer ty Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael City Of San Rafael II Statement covers period I from 01/01/2021 SUBTOTAL$ SCHEDULE A (CONT.) through 06/30/2021 page 117 of 202 I.D. NUMBER AMOUNT RECEIVED THIS PERIOD 1 17.80 13. 80.00 831.553 CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 82.10 182.10 182.10 182.10 18;x,1 FPPC Form 460 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. I ' from 01/01/2021 • ' through 06/30/2021 Page 118 of 202 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 HIS RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE TOQUIR RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE * O(IFSELPFEMP SELF-EMPLOYED, ETION AND NTER NAME (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2.021 Daisy B MazariegosX❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1.920 Fifth Avenue, San Rafael CA 94901 05/15/2021 Daisy B Mazariegos El IND Police Officer 13.30 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Daisy B Mazariegos x❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth v n Rafael. 06/15/2021 Daisy B Mazariegos X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenue, San Rafael, CA 94901 06J30 Daisy B Mazariegos [91 IND Police Officer ls.�u 18L.1U C/O: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay= ue. ❑ SCC SUBTOTAL$ 66.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from_ 01/01/2021 through 06/30/2021 SCHEDULE A Page 119 of 202 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IFCOMMITEE,ALSOENTERID.NUMBER) CODE* OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Gerard F McCarthy x❑IND Police Officer 13.90 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue San Rafael CA 9A901 — — 01/31/2021 Gerard F McCarthy 91 IND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/1212021 Gerard F McCarthy QIND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San RafaQ1. CA 94901 ❑ SCC 02/26/2021 Gerard F McCarthy RIND Police Officer 17.80 178.20 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 [IOTH Union member's dues received through E]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 7M15/2021 Gerard F McCarthy RIND Police Officer 1i.uu 17 , C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth v ❑ SCC SUBTOTAL$ 85.10 "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 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. [ * 1 from 01/01/2021 • through 06/30/2021 page 120 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 0313417.021 Gerard F McCarthy x❑IND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/1.5/2021 Gerard F McCarthy ]IND Police Officer 1:3.30 178.20 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/30/2021 Gerard F McCarthy RIND Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth u n Rafael. ❑ SCC x❑IND 05/15/2021 Gerard F McCarthy Police Officer 13.30 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 05/31/2021 Gerard F McCarthy QIND Police Orricer is.su 178.20 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth ❑ SCC SUBTOTAL$ 66.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ 601 from 01/01/2021 • ' through 06/30/2021 page 121 of 202 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 RECEIVED CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE TOQUIR RECEIVED (IF COMMITEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION(IF SELLFEMP SELF-EMPLOYED, ENTERNAME IODTHIS (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/i5 2421 Gerard F McCarthy RIND Police Officer 13.30 .178.2.) C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 152Q Fifth Avenue San Rafael CA 94901 06/30/2021 Gerard F McCarthyx❑IND Police Officer 13.30 178.26 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/15/2021 Phillip Melodia E)IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue .CA OTH San Rafael, 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 520 Fifth Avenue. San Rafapl. CA 949 ❑ SCC 01/31/2021 Phillip Melodia X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM `'ity of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 Y i ip Melo a F1 IND Officer ii.du 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94301 ❑ SCC SUBTOTAL$ ao.00 "Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 1 � from 01/01/2021 FORM Page 122 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR NDI.D.NUMBER) O CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO . CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02 T2612021 Phillip MelodiaX❑IND Officer 17.80 382.1.0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 94901 03/15/2021 Phillip Melodia 91 IND Officer 17.60 182.11) C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 11,2n Pifeh Kv up, San RafaLaj_ CA 94901 ❑ SCC 03/30/2021 lodia xIND Officer 13.30 182.10 afael Police Association 1520 Fifth ❑COM City of San Rafael EPhillip , CA 94901 ❑OTH dues received through ❑ PTY ry: San Rafael Police Association, ❑SCC 94901 04/15/2021 Phillip Melodia RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 41 Phillip Me odfa 91 IND Officer ij j 182-101 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [7]PTY intermediary: San Rafael Police Association, nue, San Rafael, g;b 94901-- © 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$ 75.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 � ' from 01/01/2021 ■' through- 06/30/2021 page 123 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) OS/1512021 Phillip Melodia x❑IND Officer 13.30 1` ; C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 94901 45/31/2021 Phillip Melodiax❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay,ni3, San Raf-1- CA 94901 ❑ SCC 06/15/2021 Phillip Melodia X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 20 Fifth Avenue. San 2,afael. QA 94901 ❑ SCC 06/30/2021 Phillip Melodia E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael [:] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael, CA 94901 --61/15/2021 Daniel Mendoza Ochoa x❑IND Police Officer i/.du 1N 2.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1,520 Fifth Avenue, San Rafael, CA 94901 ❑ 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$ 71.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. 1 from 01/01/2021 • through 06/0/2021 page 124 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR YEAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Daniel Mendoza OchoaX❑IND Police OYticer 17.80 1$2.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94201 02/12/2021 Daniel Mendoza Ochoa MIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1S20 Fifth AVPnue- San gafa�l_ CA 24901 1 ❑ SCC 02/26/2021 Daniel Mendoza Ochoa MIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, fa 1 03./15/2021 Daniel Mendoza Ochoa MIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael, CA 94901 Daniel Mendoza Ochoa 91 IND Police Otricer 13..3u 182,1 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael El COM Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth v SUBTOTAL$ 84.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through- 06/30/2021 I Page 125 of 202 I.D. NUMBER 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) intermediary: San Rafael Police Association, OF BUSINESS) 1/15/2021 Daniel Mendoza Ochoa X❑IND Police Officer 1 13.30 182.10 I82.I0 C/o: San Rafael Police Association 1520 Fifth C/o: San Rafael Police Association 1520 Fifth City Of San Rafael City Of San Rafael *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ave ue San Rafael CA 94901 Police Officer 13.30 04/30/2021 Daniel Mendoza Ochoax❑IND I82.I0 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 119n Fifth Aypn,p San Rafael- QA C14901 ❑ SCC 05/15/2021 Daniel Mendoza Ochoa El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0 A 05/31/2021 Daniel Mendoza Ochoa X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael, CA 94901 —0611512021 Daniel Mendoza Ochoa E] IND Police Ofticer 13.30 C/o: San Rafael Police Association 1520 FifthE] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Eifth Ay.= e. San R&fael. CA 9490L- ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. / 60 from 01/01/2021 • " through 06/30/2021 page 126 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 31) IF REQUIRED ( ) OF BUSINESS) 06/3()!2421 Daniel Mendoza Ochoa X❑IND Police Officer 3.30 162.1G C/o: San Rafael Police Association 1520 Fifth F] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021 Lilah MG Barnes El IND Police Corporal 17.80 182.1.0 C/o: San Rafael Police Association 1520 Fifth [-]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, [-]SCC 01/31/2021 Lilah MG Barnes 21IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [] PTY intermediary: San Rafael Police Association, ❑ SCC 9 0 02/12/2021 Lilah MG Barnes x❑IND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 02/26/2021 Lilah Barnes E] IND Police Corporal 1ti 10 .1 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q Fifth &yg4nue. San Baf&e_ 1. ❑ SCC SUBTOTAL$ 84.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period0 . , to whole dollars. 1 I I from 01/01/2021 • through 06/30/2021 Page 127 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITfEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/20fl— Lilah MG Barnes QIND Police Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [3Com of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 - 03/30/2021 Lilah MG Barnes [91 IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Ayg�n,p_ Sao P,,,Fagl CA 94901 ❑ SCC 04/15/2021 Lilah MG Barnes x❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. 4 04/30/2021 Lilah MG Barnes 21 IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 I15 Lilah 14G Barnes RIND Police Corporal i.s.Ju 82.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. S Rafael, CA 94901 ❑ SCC -an SUBTOTAL$ 71.00 'Contributor Codes IND- Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. 1 ' from 01/01/2021 ` through 06/30/2021 page 128 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 05/31/202.1. Lilah MG BarnesX❑IND Police Corporal 13.30 1821. 10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth AvenuQ, San Rafael CA 94901 66/15/2021 Lilah MG Barnes E] IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/30/2021 Lilah MG Barnes x❑IND Police Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 20 Fifth AvenuQ, 2an RAfapl. CA 94901 01/15/2021 Beth Minka El IND Administrative Technician 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/31/2021 Beth M n a RIND Administrative Technician 1j.9u 3412.30 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,1520 •r th Avenug, San Rafael, CA 91aaL_ ❑ SCC SUBTOTAL$ 67.70 *Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Parry SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period I CALIFORNIA to whole dollars. M from 01/01/2021 • through 06/30/2021 Page 129 of 202 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 IE O FULL NAME, STREET ADDRESS AND ZIP CODOF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSOD. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Beth Minka FIND Administrative Technician 13.90 142.30 C/o: San Rafael Polide Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San -Rafael. CA 94901 142.30 — 02/26/2021 Beth Minka E] IND Administrative Technician 13.90 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth Z6vPniiP_ San Raf-1 QA 94901 ❑ SCC 03/15/2021 Beth Minka El IND Administrative Technician 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth byenue. San Rafael. QA 94q01 ❑ SCC 03/30/2021 Beth Minka E] IND Administrative Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue, San Rafael, CA 94901 bet min%a E] IND Administrative Tecnnician 10.40 142.JO C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aypnue. San a ❑ SCC SUBTOTAL$ 62.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. I from 01/01/2021 � NAME OF FILER San Rafael PnlicP AGGnr-iatinn Political Action Committee through 06/30/2021 Page 130 of 202 I.D. NUMBER 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$ 52.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO .D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Beth MinkaX❑IND Administrative Technician C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/15/2021 Beth Minka E] IND Administrative Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, g4gol 152n Fifth Avenue. q., R,fApl- CA ❑ SCC 05/31/2021 Beth Minka El IND Administrative Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [3Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafael,152P Fifth Avenue. San ❑ SCC 06/15/2421 Beth Minka RIND Administrative Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 06/3012021 Beth MinkaAdministrative 'T'echnician 10.40 142.37 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael. CA 94901 ❑ 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$ 52.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. / � from 01/01/2021 FORM page 131 of 202 through 06/30/2021 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) 07/15/2021 Jessica Mitz XIND Police Officer 1%.80[ 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ave ue San Rafael CA 94901 01/31/2021 Jessica Mitz E] IND _ Police Officer 17.80 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152n Fifth ky,ni­ q,n RAL�pl CA 94901 [:]SCC 02/12/2021 Jessica Mitz FK] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Rafael- CA 02/26/2021 X❑IND Police Officer 17.80 182.10 afael Police Association 1520 Fifth ❑COM City Of San Rafael 7JessicaMitztz l, CA 94901 ❑OTH er's dues received through ❑PTY ary: San Rafael Police Association, SCC Avenue, San Rafael, CA 94901 2 Jessica Mitz x❑IND Police Orricer 1/.a u 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, 152D Fifth-Avenon. San R ❑ SCC SUBTOTAL$ 89.00 "Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC — Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A Page 132 of 202 I.D. NUMBER 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.neifile.com olice Officer ity Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael lice Ufflcer ty Of San Rafael 0 13.30 13.30 SUBTOTAL$ 66.50 182.10 182.10 182.10 182.10 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Union member's dues received through OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED ❑ SCC CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) 04/15/2021 Jessica Mitz x❑IND OF BUSINESS) C/o: San Rafael Police Association 1520 Fifth 03/30/2021 Jessica Mitzx❑IND Avenue Police OfficerI 13.301 182.10 San Rafael, CA 94901 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ PTY *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.neifile.com olice Officer ity Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael lice Ufflcer ty Of San Rafael 0 13.30 13.30 SUBTOTAL$ 66.50 182.10 182.10 182.10 182.10 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Jessica Mitz x❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue n OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, U SCC 04/30/2021 Jessica Mitz RIND C/o: San Rafael Police Association 1520 Fifth F] COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fjfth Avenue, SaD Rafael. CA 9 0 _ 05/15/2021 Jessica Mitz 21 IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 05/31/21J21 Jessica Mitz E] IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ 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.neifile.com olice Officer ity Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael lice Ufflcer ty Of San Rafael 0 13.30 13.30 SUBTOTAL$ 66.50 182.10 182.10 182.10 182.10 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I 60 from 01/01/2021 ■ through 06/30/2021 page 133 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Jessica Mitz FIND Police Officer 13.30 182-10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v nue San Rafael CA 94901 06/30/2021 Jessica Mitz [91 IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1;2(1 Pifth Aventig, Ran Bafapl- CA 949491 ❑ SCC 01/15/2021 Cynthia Morgan x❑IND Call Taker and Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 [:1OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth v an Rafael. CA 94901 01/31/2021 Cynthia Morgan x❑IND Call Taker and Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue San Rafael, CA 94901 ❑ OTH City Of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Call Taker and Records L.5. 142.30 2 12 Z I Cynthia MGrcjan Z]IND Wo: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901. ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael. CA %43_0� ❑ SCC SUBTOTAL$ 68.30 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ ' from 01/01/2021 FORM through 06/30/2021 page 134 of 202 NAMEOF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 13.90 02/26/2021 Cynthia Morgan X❑IND Call Taker and Records 1,1:'.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Aven a San Rafael CA 94901 03/15/2021 Cynthia Morgan X❑IND Call Taker and Records 13.901 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue ❑ OTH City Of San Rafael San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Cynthia Morgan RIND Call Taker and Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v CA 94901 04/15/2021 Cynthia Morgan X IND Call Taker and Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 --04/30/2021 Cynthia Morgan ❑ RIND Call Taker ana icecoras lU.4U 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fiftb Avenue. San R&L-Lga, ❑ SCC SUBTOTAL$ 59.00 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 I page 135 of 202 I.D. NUMBER 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$ 55.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2421 Cynthia MorganX❑IND Call Taker and Records 1U.4U C/o: San Rafael Police Association 1520 Fifth L] COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 D513112021 Cynthia Morgan 91IND Call Taker and Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist AvenueCity Of San Rafael San Rafael, CA 94901 [_]OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Cynthia Morgan RIND Call Taker and Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth venjAg. San 24fagl, CA 94901- 06/30/2021 Cynthia Morgan El IND Call Taker and Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue, San Rafael, CA 94901 7 111512021 Lynn Murphy RIND Mental Health outreach 13.90 142.30 C/o: San Rafael Police Association 1520 FifthProvider ❑ COM Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafa�al, Ch 94991 - [:]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$ 55.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 4601 � ' from - 01/01/2021 • " page 136 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01137.1207.1 Lynn MurphyxIND ❑ Mental Health Outreach 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue San Rafael CA 94901 02/12/2021 Lynn Murphy ElIND Mental Health Outreach 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth []COM Provider Avenue ❑ OTH City of San Rafael San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, IS20 Fifth Ay-nug- San Rafapl- CA 94901 ❑ SCC 02/26/2021 Lynn Murphy X IND Mental Health Outreach 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM Provider Avenue City of San Rafael San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, CA [:]SCC 03/15/2021 Lynn Murphy xIND Mental Health Outreach 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael CA 94901 03/30/2021 Lynn Murphy X❑ IND Mental heaitn Outreach 4 14 L C/o: San Rafael Police Association 1520 FifthProvider ❑ COM Avenue San Rafael, CA 94901 [_]OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, f ❑ SCC SUBTOTAL$ 66.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers periodFPage to whole dollars.from 01/01/2021through 06/30/2021 137 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE 742 (IF COMMITTEE, ALSO ENTER LD, NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) _ Lynn Murphy QIND Mental Health Outreach 10.40 3 .' C/o: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 142.30 04/3612021 Lynn Murphy RIND Mental Health Outreach 10.40` C/o: San Rafael Police Association 1520 Fifth [-]COM Provider Avenue City of San Rafael San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avon— San Raf-1- CA 94901 [-]SCC 05/15/2021 Lynn Murphy x❑IND Mental Health Outreach 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM Provider Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC IS�O Fifth Avenue. San Rafael, CA 94901 05/31/2021 Lynn Murphy X❑IND Mental Health Outreach 10.40 142.30 C/O: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 --66/1512021 Lynn Murp y X❑IND Mental Health Outreach 10.40 i42.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth A-venAie. Zan Raft CA 94901 [:]SCC -el. SUBTOTAL$ 52.00 'Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC- Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. 1 t from 01/01/2021 � through 06/30/2021 Page 138 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/34/2021 Lynn Murphy X❑IND Mental Health Outreach 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Provider Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth avenue, San Rafael CA 94901 01/15/2021 Brandon Nail El IND Police Officer 1%.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, S20 Fifth gn,�, San Rafapl, CA 94901 ❑ SCC Brandon Nail x❑IND Police Officer 17.80 182.10 ,01131/2021 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fiftil Amenl3e, San Rafael. CA 94901 02/12/2021 Brandon Nail E] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Brandon Nail RIND Police Of icer li.du _ .10 82 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue ❑ SCC SUBTOTAL$ 81.60 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Parry SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period to whole dollars. Ir from 01/01/2021 through 06/30/2021 Page 139 of 202 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 RECEIVED THIS CUMULATIVE TO DATE YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Brandon Nail x❑IND Police Officer 782-10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/30/2021 Brandon Nail E]IND Police Officer 13.30 192.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/15/2021 Brandon Nail RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC Fifth C 94901 04/30/2021 Brandon Nail x❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 1 Brandon Nail X❑IND Police Officer 1.3.JU 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael [:] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1590 Fifth ElSCC SUBTOTAL$ 71.00 "Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity; PTY— Political Party SCC—Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period_ to whole dollars. 1 from 01/01/2021 F 140 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE RECEIVED THIS PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER CALENDAR YEAR (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/2021 Brandon NailX❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael. CA 94901 06/15/2021 Brandon Nail Z1 IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [3Com City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafa.1- CA 94901 []SCC 06/30/2021 Brandon Nail ®IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafapl. CA 94901 01/15/2021 Jorge Navarro X❑IND Evidence Technician 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/31f2021 Jorge Navarro RIND Evidence Technician 1.3.90 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth 9 "Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC—Small ContributorCommittee www.netfile.com SUBTOTAL$ 67.70 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period _ a to whole dollars. 1 from 01/01/2021 " page 141 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER .D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02I12I2021 Jorge Navarro X❑IND Evidence Technician 13.90 142.,30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/26/2021 Jorge Navarro El IND Evidence Technician 13.90 4�. •`.' C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 949-0-L- ❑ SCC 03/15/2021 Jorge Navarro x❑IND Evidence Technician 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fi�th Avenue, San Rafael, A 94901 03/30/2021 Jorge Navarro 7❑IND Evidence Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 04/15/2071 Jorge Navarro E] IND Evidence Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue- [:]SCC SUBTOTAL$ 62.50 *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 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period _ to whole dollars. ' from 01/01/2021 a through 0 6/30 /2021 page 142 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO LD NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2021 Jorge Navarro X❑IND Evidence Technician 10.40 142.30 C/o: San Rafael Police Association 1520 FifthE] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue S n Rafael CA 94901 05/15/2021 Jorge Navarro El IND Evidence Technician 10.40 .142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 05/31/2021 Jorge Navarro x❑IND Evidence Technician 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1'20 Fifth Aven e. San9 06/15/2021 Jorge Navarro E] IND Evidence Technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 0 Jorge Navarrox❑IND Evidence 'technician 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Raga�l- CA 94aal ❑ SCC SUBTOTAL$ 52.00 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.neifile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. ■ , from 01/01/2021 • through 06/30/2021 page 143 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 ND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE 7RRECE71VED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15Alexis Nielsen x❑IND Lead Communications 13.90 142.3a C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/31/2021 Alexis Nielsen 91 IND Lead Communications 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1S20 Fifth Aypnijg_ San Pafap-1 Q4qnl ❑ SCC 02/12/2021 .(A Alexis Nielsen x❑IND Lead Communications 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC IS20 Fifth Avenue. 02/2612021 Alexis Nielsen E] IND Lead Communications 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 Alexis Nielsen RIND Lea Communications C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]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$ 69.50 , FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ * ` from 01/01/2021 • ' through 05/30/2021 page 144 of 202 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 THIS PER ELECTION TO DATE DATE (IFCOMMITTEE,ALSOENTERI.D.NUMBER) * OCCUPATION AND EMPLOYER RECEIVED CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 103/30/202 Alexis NielsenX❑IND Lead Communications 10.40 142.30 C/O: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Alexis Nielsen 91 IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth El COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/30/2021 exis Nielsen E] IND Lead Communications 10.40 142.30 o: San Rafael Police Association 1520 Fifth [:]COM Dispatcher enue City of San Rafael n Rafael, CA 94901 [Union ❑ OTH member's dues received through ❑PTY termediary: San Rafael Police Association, ❑ SCC 0 Fifth Avenue. San RafaQ1. CA 9A901 05/15/2021 Alexis Nielsen X❑IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 R /31/2021 Alexis NielsenOIND Lead Communications - •4 G 142.30 C/o: San Rafael Police Association 1520 Fifth COM Dispatcher Avenue ❑ City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1590 Fifth Ayenue. San Rafapl. CA 94901 SUBTOTAL$ 52.00 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC—Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. ■t from 01/01/2021 through 06/30/2021 page 145 of 202 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 RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 10.40 142.30 06/15/2021 Alexis NielsenQIND Lead Communications C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San RafLQ1. CA 94901 06/30/2021 Alexis Nielsen x❑IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth X�ypj5­ R—n Paf-1- CA 94(301 ❑ SCC 01/15/2021 Oscar O'con x❑IND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, Sari Rafael. CA 2 qnl 01/31/2021 Oscar O'con QIND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 0 Oscar con E] IND Corporal 1 • 80 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenae. San_Rdj,&gj. CA 24901 ❑ SCC SUBTOTAL$ 74.20 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 � ' from 01/01/2021 • " through 06/30/2021 page 146 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 62/26/2021 Oscar O'con I MIND Corporal 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/15/2021 Oscar O'con X❑IND Corporal 17.80 187..10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ;S20 Fifth Aygnu­ -q,n RAfa�_l CA 94901 ❑ SCC 03/30/2021 Oscar O'con X❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avel. ❑ SCC 04/15/2021 Oscar O'conX❑IND Corporal 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 scar con [91 IND Corporal 13.3U 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, 1520 Fifth Aykmlar, Zan Rafael, CA 94901 ❑ SCC SUBTOTAL$ 75.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 Page 1 I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT DATE OCCUPATION AND EMPLOYER RECEIVED THIS RECEIVED (IF COMMITTEE, ALSO ENTERI.D.NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD OF BUSINESS) Q5/15/2021 Oscar O'con X❑IND Corporal 13.30 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael *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 orporal ity Of San Rafael Corporal City Of San Rafael Corporal City Of San Rafael spatcner ty Of San Rafael 13.30 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 182.1 182.10 13.301 182.10 SUBTOTAL$ 67.10 47 of 202 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 2 Fifth Avenue San Rafael CA 94901 Q5/31/2021 Oscar O'con 91 IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Oscar O'con E] IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. ❑ SCC 06.130/2021 Oscar O'con X❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 01/1512021 Elizabeth Paez X❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, I- r -s w-.��..� a-- a-e� !-T nAnAl ❑ 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 orporal ity Of San Rafael Corporal City Of San Rafael Corporal City Of San Rafael spatcner ty Of San Rafael 13.30 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 182.1 182.10 13.301 182.10 SUBTOTAL$ 67.10 47 of 202 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 51/32/2021 Elizabeth Paez X❑IND Dispatcher C/o: San Rafael Police Association 1520 Fifth City Of San Rafael r "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 ispatcher ity Of San Rafael Dispatcher City Of San Rafael spatcher ty Of San Rafael spatcner ty Of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through- 06/30/2021 Page 148 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 13.901 142.30 13.901 142.30 66.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 24 01 02/12/2021 Elizabeth Paez X❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Elizabeth Paez El IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 520 Fifth Avenue. 03.115/2021 Elizabeth Paez X❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 03/30/2021 Elizabeth Paez X❑IND C/o: San Rafael Police Association 1520 Fifth F1 COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through F-1PTY intermediary: San Rafael Police^ Association,nAnni ❑ SCC r "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 ispatcher ity Of San Rafael Dispatcher City Of San Rafael spatcher ty Of San Rafael spatcner ty Of San Rafael SUBTOTAL$ SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through- 06/30/2021 Page 148 of 202 I.D. NUMBER 831553 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 13.901 142.30 13.901 142.30 66.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. from 01/01/2021 • ' through 06/30/2021 page 149 of 202 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 OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/1512 21 Elizabeth Paez X❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 04/30/2021 Elizabeth Paezx❑IND Dispatcher 10.40 142.367 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay—ij— Jan Raf-1- CA 94901 ❑ SCC 05/15/2021 Elizabeth Paezx❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 0 Fifth Avenue. San RafQpl. CA 94901 05/31/2021 Elizabeth Paez ❑x IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael, CA 94901 6 1 2 2 E 1Za et aez X❑ IND Dispatcher iu.4u 14..3 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenut,-, San R&Laul. CA 24901 [:]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$ 52.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. I ' from 01/01/2021 " through 06/30/2021 page 150 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE* OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/2021 Elizabeth PaezX❑IND Dispatcher 1U.4U 142.3[ C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue .San Rafael. CA 94901 01/15/2021 Brian Patterson MIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 Brian Patterson ]IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafael,1520 Fifth Avenue. SgI2 ❑ SCC 02/12/2021 Brian Patterson MIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA, 94901 UW/26/2021 Brian Patterson E] IND Officer li.uu 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, S ❑ SCC SUBTOTAL$ 81.60 *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 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Mnnptary Cnntributinns Received SCHEDULE A (CONT.) Amounts may be rounded Statement covers period - - - -o whole o ars. � from 01/01/2021 4 through 05/30/2021 page 151 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR NDI.D.NUMBER) O CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO . CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 133115/2021 Brian PattersonX❑IND Officer 17.8U C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/30/2021 Brian Patterson DIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/15/2021 Brian Patterson BIND Officer 1 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1S20 Fifth Avenue. San Rafae_L._'CA_ 0 04/30/2021 Brian Patterson X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through EIPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 75/15/2021 Brian Patterson RIND Officer 1.5.3u 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San—Rafael. CA 94MI ❑ SCC SUBTOTAL$ 71.00 *Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period• . to whole dollars. I ' from 01/01/2021 • through 06/30/2021 Page 152 of 202 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 TO DATE DATE (IF COMMITTEE, ALSO ENTER ID NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/2021 Brian Patterson RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 06/15/2021 Brian Patterson X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San R�f­l_ CA 94901 ❑ SCC 06/30/2021 Brian Patterson El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0490 01/15/2021 Dennis Prince X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 01/31/2021 Dennis Prince X❑IND Officer 1r.8`Y 18 0 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth '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$ 75.50 i FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers periodFF9 to whole dollars.from 01/01/2021through 06/30/2021 NAME OF FILER LD, NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ZIP CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 112 2021 Dennis Prince MIND Officer C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 0212617.021 Dennis Prince MIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 119C) Pift-h Aypnup. San Rafael, QA 94201 ❑ SCC 03/15/2021 Dennis Prince MIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avpnlje. San 94901- 03130/2021 Dennis Prince MIND officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 04115 Dennis Prince MIND Otticer 1 82.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1590 Fifth Avenue, ❑ 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$ 80.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period �. to whole dollars. ' from 01/01/2021 through 06/30/2021 Page 154 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT THIS CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 04/3012021 Dennis PrinceX❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520.Fifth Avenue San Rafael CA 94901 05/3.5/2021 Dennis Prince `x[IIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Dennis Prince RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth AvenuQ. San Rafael. CA 94901 06/15/2021 Dennis Prince E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 Dennis Prince RIND officer 13.30 .10 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aven�je. San Rafael, CA A ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. / ' from 01/01/2021 ■ ' through 06/30/2021 page 155 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Edgar Rodriguez KIND Police Officer 17.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1524 Fifth Avenue San Rafael, CA 94401 01/31/2021 Edgar Rodriguez x❑IND Police Officer 17.80 187..10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 02/12/2021 Edgar Rodriguez El IND lPolice Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ay0 02/26/2021 Edgar Rodriguez RIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Cifth Avenue, San Rafaell CA 94901 Edgar BO r..guez x❑IND Police Officer 1/.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue- San R -f-- , CA 94901 ❑ 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$ 89.00 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded statement covers period �. to whole dollars. 1 NAME OF FILER San Rafael Police Association Political Action Committee from 01/01/2021 through 06/30/2021 ! page 156 of 202 I.D. NUMBER 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO 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. 31) IF REQUIRED ( ) OF BUSINESS) _ 03/30/2021 Edgar Rodriguez X❑IND Police Officer 3.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Edgar Rodriguez x IND Police Officer 13.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, la2f) Fifth Avenue, Sao Rafanl, CA 94901 ❑ SCC 04/30/2021 Edgar Rodriguez x❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth-Ayen e. San Rafgel. CA 94901 05/15/2021 Edgar Rodriguez H] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth[:] COM `'ity Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 05/31/2021 Edgar Rodriguez X❑IND Police Officer lj.iU 182.10 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avenue. San Rafael, CA 144M ❑ SCC SUBTOTAL$ 66.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER C.., D. -F-1 Pnli— Acc 'iati— PnliI- i — I Ari - i nn CnmmittPP Amounts may be rounded to whole dollars. SCHEDULE A Statement covers period from 01/01/2021 through 06/30/2021 Page 157 of 202 I.D. NUMBER 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE* OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Edgar Rodriguez X❑IND Police Officer 13.30 187.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Ra ael CA 94901 0.6/30/2021 Edgar Rodriguez QIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Aygn­_ -q.n R, apl, CA 94901 ❑ SCC 01/15/2021 Noemi Rossotti Gallo x❑IND Police Officer 17.80 182.10 C/O: San Rafael Police Association 1520 Fifth ❑{COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth San Rafagl, CA 94901 ❑ SCC 01/31/2021 -Avenue. Noemi Rossotti Gallo 7] IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police.Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 02/1212021 Noemi Rossotti Gallo RIND Poiice Otticer 1/.80 192.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTS( intermediary: San Rafael Police Association, [:]SCC 1120 Fifthv n Rafael. CA 9 SUBTOTAL$ 80.00` "Contributor Codes IND=Individual COM – Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY– Political Party SCC–Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period e . to whole dollars. ■ ■ NAME OF FILER San Rafael Police Association Political Action Committee from 01/01/2021 through 06/30/2021 I Page 158 of 202 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR 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) 02/26 2 1 Noemi Rossotti Gallo ]IND Police Officer 17.80 182.1.0 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 03/15/2021 Noemi Rossotti Gallo EIIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM "ity of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenuo San RafAp-l- C46 94901 ❑ SCC 03/30/2021 Noemi Rossotti Gallo ElIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through El PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenup.an Rafafj. CA 94901 04/15/2021 Noemi Rossotti Gallo QIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 04 Noemi Rossotti Ga o X❑IND Police UfflCer 1 82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: SanRafael Police Association, 1520 Fifth Aman 11 e San Rafaej__CA__2A20j_ ❑ SCC SUBTOTAL$ 75.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. 1 � from 01/01/2021 FORM through- 06/30/2021 Page 159 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Noemi Rossotti Gallo X❑IND Police officer 13.30 162.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05131/2021 Noemi Rossotti Gallo 91 IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Noemi Rossotti Gallo®IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:)PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, n Rafael, 06/30/2021 Noemi Rossetti Gallo El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 _ 1 2 1 Peggy Ruge RIND Lead Communications 13.9 14 •_U C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San gslfael, CA 94901 ❑ 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$ 67.10 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. from 01/01/2021 � through 06/30/2021 page 160 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2921 Peggy Ruge X❑IND Lead Communications 13.90 142.36 C/O: San Rafael Police Association 1520 FifthDispatcher ❑ COM Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Aven San Rafael CA 94901 02/12/2021 Peggy Ruge ElIND Lead Communications 13.90 1.42.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher AvenueCity [_]OTH of San Rafael San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 Fifth Avenue Ran Rafael, CA 94901 ❑ SCC 02/26/2021 Peggy Ruge ;{IND Lead Communications 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth ❑ SCC 03/15/2021 Peggy Ruge E] IND Lead Communications 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 [_]OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 03/30/2021 Peggy Ruge RIND Lead Communications 10.4u 30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 9j2Qj__ ❑ SCC SUBTOTAL$ 66.00 *Contributor Codes IND—Individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC— Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period I CALIFORNIA to whole dollars. 1 1 from 01/01/2021 O through 06/30/2021 page 161 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1-DEC..31) (IF REQUIRED) OF BUSINESS) 10.40 04/15/2421 Peggy RugeX❑IND Lead Communications 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/3012021 Peggy Ruge 91 IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth El COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Peggy Ruge N1 IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Zifth avenue. San Rafael. CA — 05/31/2021 Peggy Ruge E] IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 2021 Peggy Ruge _ x❑IND Lead communications 10.40 141. 30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue San Rafael, CA 94901 ❑ OTH City of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 942DL- ❑ SCC SUBTOTAL$ 52.00 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC— Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ � from 01/01/2021 FORM page 162 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/30/2021 Peggy Ruge X IND Lead Communications 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Dispatcher Avenue City of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, A 94901 01/15/2021 Travis Ruggles X❑IND Police Officer 17.80 192.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 15 n Fifth Avenup.. San Rafael. CA 94901 ❑ SCC - 01/31/2021 Travis Ruggles RIND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 F-iftb Avi-nue, San Rafael, 02/12/2021 Travis Ruggles x❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [3Com City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 —02/26/2021 Travis Rugg es M IND Police Officer ii.bu 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL $ 81.60 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through 06/30/2021 page 163 of 202 I.D. NUMBER 831553 DATE FULL NAME, STREET ADDRESS P CODE OF CONTRIBUTOR AND ZI CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR RECEIVED (E COMMITTEE, ALSO ENTER LD NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) OF BUSINESS) 03/15/2021 Travis RugglesX❑IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San RafAql, CA 94901 — 03/30/2021 Travis Ruggles QIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/15/2021 Travis Ruggles E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 20 Fifth Ayen San Rafael. CA 94901 04/30/2021 -e. Travis Ruggles X IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth E] COM "ity of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, Sart Rafael, CA 94901 05/1512021 Travis Ruggles E] IND Police Officer 13.30 182.1 C/o: San Rafael Police Association 1520 Fifth City of San Rafael [-]Com Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary_ San Rafael Police ^Association, ❑ 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.nefile.com SUBTOTAL$ 71.00 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period 1111111191:401 to whole dollars. from 01/01/2021 •through F 06/30/2021 Page 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO -D. CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/31/7021 Travis Ruggles RIND Police Officer 13.30 82.1' C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC 1520 Fifth Avenue San Rafael CA 94901 Police Officer 06/15/2021 Travis Ruggles 91 IND 13.30 :=.'•`' C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ Sc 06/30/2021 Travis Ruggles RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, SaRafael- 01/15/2021 Jessica Sanchez E] IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue, San Rafael, CA 94901 --61/3112021 Jessica Sanchez MIND Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Specialist Avenue San Rafael, CA 94901 [_]OTH City Of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. [:jSCC "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$ 67.70 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period , • . , to whole dollars. I 0 , from 01/01/2021 • ' through 06/30/2021 page 165 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 TE ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE IVED 7022 (E COMMITTEE, ALSO ENTER I D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) /72 Jessica Sanchez x❑IND Call Taker/Records 1J.9U 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue San Rafael CA 91901 02/26/2021 Jessica Sanchez 91 IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avenue., Baf�pl, CA 94901 ❑ SCC 03/15/2021 -San Jessica Sanchez x❑IND Call Taker/Records 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth []COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. 90 03/30/2021 Jessica Sanchez RIND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 04/15/2071 Jess ca Sanchez El IND Call Taker/Records iu.40 142.JU C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue San Rafael, CA 94901 ❑ OTH City Of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,152n Fifth Avenjae. San Rafael. CA P ❑ 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$ 62.50 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period to whole dollars. ■ from 01/01/2021 ■ through 06/30/2021 Page 166 of 202 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 RECEIVED THIS CUMULATIVE TO DATE YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 - DEC. 31) IF REQUIRED ( ) OF BUSINESS) 09I3L712021 Jessica SanchezX❑IND Call Taker/Records 10.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue San Rafael CA 94901 05/15/2021 Jessica Sanchez x❑IND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, 1520 Fifth Aygnup, -qAn Rafael. CA 94901 ❑ SCC 05/31/2021 Jessica Sanchez E] IND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1�20 Fifth Avenue, San Rafael, 0 06/15/2021 Jessica Sanchez X❑IND Call Taker/Records 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth []COM Specialist Avenue City Of San Rafael San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael CA 94901 06/30/2021 less ca San❑ ez x❑IND Cali 'faker/ ecoras l0. v0 .91..30 C/o: San Rafael Police Association 1520 Fifth ❑ COM Specialist Avenue San Rafael, CA 94901 ❑ OTH City Of San Rafael Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San RaFaj-1. CA 1342QL- ❑ SCC SUBTOTAL$ 52.00 *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity; PTY - Political Party SCC - Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. 1 from 01/01/2021 FORM through 06/30/2021 Page 167 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION TO DATE DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR YEAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/15/2021 Sebastian SanchezX❑IND Police Officer 17.80 182.10 C/O: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenye. San Rafael CA 94901 01/31/2021 Sebastian Sanchez x❑IND Police Officer 11.80 182.3.0 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/12/2021 Sebastian Sanchez x❑IND Police Officer 17.80 182.10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC U v 0 02/26/2021 Sebastian Sanchez El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 03/15/2021 Sebastian Sanchez X❑IND Police Otticer ii.uu 1 S T71 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Fifth1520 v SUBTOTAL$ 89.00 *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC - Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. 1 60 from 01/01/2021 f through 06/30/2021 Page 168 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/30/2021 Sebastian Sanchez X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 04/15/2021 Sebastian Sanchez El IND Police Officer 13.30 187.]0 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 04/30/2021 Sebastian Sanchez k❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0 901_ 05/15/2021 Sebastian Sanchez X❑IND olice Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl ity Of San Rafael COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 --05/3112021 Sebastian Sanchez 71 IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth L] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC .1520 ;f r SUBTOTAL$ 66.50 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC—Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period _ to whole dollars. / from 01/01/2021 Page 169 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT THIS CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED PERIOD CALENDAR YEAR (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2621 Sebastian Sanchez El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, El SCC 1520 Fifth Avenue San Rafael CA 94901 06/30/2021 Sebastian Sanchez [KIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth []COM City Of San Rafael Avenue OTH San Rafael, CA 94901 K Union member's dues received through K PTY intermediary: San Rafael Police Association, IS20 Fifth Avonug- San Rafanl_ CA24901 ❑ SCC 01/15/2021 Anthony Scalercio ®IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152Q Fifth Avenue. San Rafn,-.1. CA q49n1 K SCC 01/31/2021 Anthony Scalercio X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [-]Com City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑SCC 1520 Fifth Avenue, San Rafael, CA 94901 1 Anthony Scalercio [R] IND Officer ii.uu C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth1520 ElSCC SUBTOTAL$ 80.00 *Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.nefile.com Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Can Pnf-1 Pnli— Ac r iatinn Pnlitioal Act inn Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 01/01/2021 through. 06/30/2021 page 170 of 202 I.D. NUMBER 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED 702 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ Anthony ScalercioX❑IND Officer C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1570 Fifth Avenue San Rafael CA 99901 03/15/2021 Anthony Scalercio X❑IND Officer 17.80 197.;:" C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Anthony Scalercio x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avel-11je. San Rafael. CA 94901 ❑ SCC 04/15/2021 - Anthony Scalercio X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 74/30/2021 Anthony Sca ercio x❑IND Otticer li..iu C/o: San Rafael Police Association 1520 Fifth L] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [:]PTY intermediary: San Rafael Police Association, 152Q Fifth v ❑ SCC SUBTOTAL$ 75.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. from 01/01/2021 FORM through 06/30/2021 Page 171 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO I.D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Anthony Scalercio X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael. CA 94901 05/31/2021 Anthony Scalerciox❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/15/2021 Anthony Scalercio X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue.n -- 06/30/2021 Anthony Scalercio EjIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/15/2021 Justin Schraeder RIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth ❑ SCC SUBTOTAL$ 71.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers periodCALIFORNIA I ' to whole dollars. I • NAME OF FILER Q., P�f­l D.,11 -o Zi--iat-inn Pnliti — I Artinn Cnmmittea from 01/01/2021 through 06/30/2021 Page 172 of 202 I.D. NUMBER 831553 DATE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR NDI.D. CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 01/31/2021 Justin Schraeder RIND Officer 17.80 lF: C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/12/2021 Justin Schraeder X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Justin Schraeder ElIND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth A� 03/15/2021 Justin Schraeder E] IND officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 Just -in Sc rae er ZIIND Officer i3.3 1 1CI C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC SUBTOTAL$ 84.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded f statement covers periodCALIFORNIA ' to whole dollars. 1 a NAME OF FILER San Rafael Police Association Political Action Committee from 01/01/2021 through 06/30/2021 page 173 of 202 IN 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15 7021 Justin SchraederX❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1,520 -Fifth Avenue San Rafael CA 94901 04/30/2021 Justin Schraeder x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]Com City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ayenue.'_q�a aogogl- CA 94901 ❑ SCC 05/15/2021 Justin Schraeder x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth v fael. CA 94901 05/31/2021 Justin Schraeder El IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 061 Justin Schraeder E] IND Officer 13.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 9 ❑ SCC SUBTOTAL$ 66.50 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. I � ' from 01/01/2021 • " through 06/30/2021 page 174 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (IF COMMITTEEALSOI.D. NUMBER) , CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/2021 Justin Schraeder MIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/15/2021 Wanda Spaletta RIND Sergeant 17.80 102.30 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/31/2021 Wanda Spaletta X❑IND Sergeant 17.80 102.30 C/o: San Rafael Police Association 15'20 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0 Fifth Avenue, San R�jfjipj. CA 94901 02/12/2021 Wanda Spaletta X❑IND Sergeant 17.80 102.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 Wanda Spaletta 91 IND Sergeant li.bu C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San BAfagdl CA 94901 [:]SCC SUBTOTAL$ 84.50 *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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ � from 01/01/2021 FORM through 06/30/2021 page 175 of 202 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 RECEIVED CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE TOQUIR RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * O(IFSELPFEMPPLOTION YED, END NTER NAME IODTHIS (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Wanda Spaletta X❑IND Sergeant 17.80 102.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/30/2021 Wanda Spaletta ®IND Sergeant 13.30` 102.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 01/15/2021 Natassja B. Springer ®IND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue. Saa Rafael. CA 0 01/31/2021 Natassja B. Springer WIND Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue Sari Rafael, CA 94901 - -77712/2021 Natassja B. Sprigger RIND Dispatcher 14.. 30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Zifth Avenue, San gafaaI, CA 54901 *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$ 72.80 FPPC Form 460 (Jan/2076) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period to whole dollars. 1 i from 01/01/2021 Page 176 of 202 through 06/30/2021 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 RECEIVED CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION DATE O RECEIVED (IFCOMMITfEE,ALSOENTERI.D.NUMBER) CODE * D (I SELF-EMAP SELF-EMPLOYED, ENTER NAME DTHIS PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) R EQU OF BUSINESS) _ 02/26/2621 Natassja B. Springer x❑IND Dispatcher 13.90 1.42.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 152-0 Fifth Avenue, San Rafael CA 94901 — 03/15/2021 Natassja B. Springer QIND Dispatcher 13.90 152.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/30/2021 Natassja B. Springer QIND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC A 04/15/2021 Natassja B. Springer El IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 74/3012OZI Natassja B. Springer!IND Dispatcher 10 4.0 142.3n C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth -Avenue. -San Rafael. CA 942DI ❑ 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$ 59.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period 6^,..6^1er,^!!,rS • - _ ----------------- of/ol/zozl - . .fromthrough 06/30!2021 177 of 202NAME 7DNUMBER 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 (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) - p5 15/2021 Natassja B. Springer RIND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael. CA 94901 OS/31/2021 Natassja B. Springer x❑IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, Avenue. San-Ra-f,pl- CA 94901 ❑ SCC 06/15/2021 Natassja B. Springer El IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [:]PTY intermediary: San Rafael Police Association, ❑ SCC Fifth AvgnkQ. can Rafael, 49 06/30/2021 _IL20 Natassja B. Springer E] IND Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 t Lynette Starnes ©IND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, []SCC 1520 Fifth Avenijo. San Baftel. CA 94901 '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$ 55.50 J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement covers period , to whole dollars. A ` from 01/01/2021 through 06/30/2021 7Pag.�3_178 of 202 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 -DEC. 31) (IF REQUIRED) OF BUSINESS) 142.30 01/31 2 21 Lynette Starnes QIND Community Service Officer 13.90 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 Q OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, F [SCC 1520 Fifth Avenue San Rafael A 94901 02/12/2021 Lynette Starnes QIND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Lynette Starnes El IND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Ayenj2e, Sari Rafael. CA 94901 03/15/2021 Lynette Starnes RIND Community Service Officer 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 --03/30/2021 Lynette Starnes [g] IND Community Service Officer lu.vu 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ;FCA 94901 El SCC SUBTOTAL$ 66.00 *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. ■ 60 from 01/01/2021 FORM through 05/30/2021 Page 179 of 202 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 ND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/15/2021 Lynette StarnesX❑IND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 94901 04/30/2021 Lynette Starnes 't IND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/15/2021 Lynette Starnes ©IND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. CA 94901 05/3112021 Lynette Starnes EIIND Community Service Officer 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [:]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 1520 Fifth Avenue San Rafael, CA 94901 06/15/2021 Lynette Starnes QIND Community Service Officer 10.40 142,30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San R&L&e 1. ❑ SCC SUBTOTAL$ 52.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER cam.. D 4Po l o..1i..o Pn1;ri-1 Artinn r—ittaa Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE A (CONT.) Page 180 of 202 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$ 81.60 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITfEE,ALSO ENTER ID.NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/301242] Lynette Starnes X❑IND Community Service Officer 10.40 " -=- C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01/1512021 Remington Stobo UIND Police Officer 17.80 182.1 Ci C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC 01/31/2021 Remington Stobo El IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. Sa_n Ba� , CA 490_ 02/12/2021 Remington Stobo E] IND Police Officer 17.80 182.10 C/O: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 02/26/2021 Remington St0 G E] IND Police Officer ii.iiu C/O: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC Ave1520 Fiftb O 'Contributor Codes IND -individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com SUBTOTAL$ 81.60 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. ■ 60 from 01/01/2021 FORM page 181 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) _ 03/1.5/2021 Remington StoboX❑IND Police Officer 7.80 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 71SCC 1520 F' t Avenue San Rafael A 94901 03/30/2021 Remington Stobo RIND Police Officer 13.30 162.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 04/15/2021 Remington Stobo E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fi9tb Avenue, San Rafael, A 04/30/2021 Remington Stobo E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 05/15/2021 Remington stobo X❑IND Police Otticer i.5_30 i 0 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Aygnue. San CA 949DL_ [:]SCC I -Rafael, SUBTOTAL$ 71.00 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC—Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. SCHEDULE A (CONT. Statement covers period from 01/01/2021 through 06/30/2021 I Page 182 of 202 I.D. NUMBER 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.nelffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 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) 05/31/2021 Remington Stobo RIND Police Officer 13.30 182,ID C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 {16/15/2021 Remington Stobo X❑IND Police Officer 13.30 i82.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 06/30/2021 Remington Stobo RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1-520 Fifth Avenug, San Rajael. CA 94901 [:]SCG 01/15/2021 Charly Taylor E] IND Civilian Supervisor 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 --01/3112021 Char y Taylor [91 IND Civilian Supervisor 1s.90 142.30 C/o: San Rafael Police Association 1520 Fifth City of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Fifth Avenue. San R ❑ SCC .152Q SUBTOTAL$ 67.70 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee www.nelffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period, to whole dollars. , from 01/01/2021 • through 06/30/2021 Page 183 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 02/12/2021 Charly Taylor X❑IND Civilian Supervisor 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [:JOTH Union member's dues received through E]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02/26/2021 Charly Taylor E] IND Civilian Supervisor 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/15/2021 Charly Taylor ®IND Civilian Supervisor 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [] PTY intermediary: San Rafael Police Association, 1520 FifLh Aveiiue. San Rafael. CA 94901 ❑ SCC 03/30/2021 Charly Taylor X❑IND Civilian Supervisor 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 04/15/2021 Charly Taylor X❑IND Civilian Supervisor _L0 40 142.30 C/o: San Rafael Police Association 1520 Fifth E] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association,_15 ❑ SCC 7 if *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.ne[file.com SUBTOTAL$ 62.501 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. / � from 01/01/2021 FORM through 06/30/2021 page 184 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 0413.0 2021 Charly Taylor X❑IND Civilian Supervisor 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth [-]Com City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 05/15/2021 Charly Taylor El IND Civilian Supervisor 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Charly Taylor x❑IND Civilian Supervisor 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC avenue,1520 Fifth 1 A 9 06/15/2021 Charly Taylor X❑IND Civilian Supervisor 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 1 Charly Tay or x❑IND Civilian Supervisor lU.14 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC C' SUBTOTAL$ 52.00 "Contributor Codes IND—Individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC —Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. � � from 01/01/2021 FORM through 06/30/2021 Page 185 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 01/151207.1 Jessica Trujillo RIND Officer i7.80 182.11) C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 152Q Fifth Avenue San Rafael CA 94901 01/31/2021 Jessica Trujillo X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152n Fifth Avpnu� q,n P,fAP1_ CA 9490 ❑ SCC 02/12/2021 Jessica Trujillo x❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 [_]OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC D Fifth A-y-enue.an R 1 CA 94901 02/26/2021 Jessica Trujillo X❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 2021 Jessica Trujillo QIND Officer 17.80 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC Fifth aygnue. San Rafael. CA 1 .1520 SUBTOTAL$ 89.00 'Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. � � from 01/01/2021 FORM through 06/30/2021 page 186 of 202 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 RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID.NUMBER) CODE* OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 03/30/2021 Jessica TrujilloX❑IND Officer 13.30 I C/o: San Rafael Police Association 1520 Fifth [:] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [:]SCC 1520 Fifth Avenue Rafael CA 94901 04/15/2021 Jessica Trujillo E] IND Officer 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, CA CIA901 ❑ SCC 04/30/2021 Jessica Trujillo RIND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1;20 Fifth &venue. San R el A 9490 05/15/2021 Jessica Trujillo X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 --05/3112921 Jessica Trujillo E] IND Officer 13.30 - 2 I.J C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC 1520 Fifth *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$ 66.50 _J FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. 460 from 01/01/2021 FORM through 06/30/2021 Page 187 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO .D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD CALENDAR (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2021 Jessica Trujillo X❑IND Officer 13.:10 187..10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1 5 20 Fifth Avenile, San Rafael CA 94901 06/30/2021 Jessica Trujillo x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue []OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Q SCC 01/15/2021 Saskia Van Buuren BIND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, [-]SCC Fifth n Rafael, CA 2a901 01/31/2021 Saskia Van Buuren x❑IND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 02/12121321 Saskia Van Buuren RIND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ElSCC n Fifth Avenue. San Rafag1__QA__14.LU SUBTOTAL$ 68.30 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement covers period �. to whole dollars. / from 01/01/2021 through 06/30/2921 page 188 of 202 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 RECEIVED THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 02/2fi12021 Saskia Van BuurenX❑IND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth E] COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through []PTY intermediary: San Rafael Police Association, ❑ SCC 15-20 Fifth Avenue, San Rafael, CA 94901 03/15/2021 Saskia Van BuurenX❑IND Communications Dispatcher 13.90 142.30 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ElPTY intermediary: San Rafael Police Association, 1520 Fifth Aynnug. -q-n R -fa -1, CA 94901 ❑ SCC 03/30/2021 Saskia Van Buuren BIND Communications Dispatcherl 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1529 FifLh Aveni�e. San Rafael. CA 94901 ❑ SCC - 04/15/2021 Saskia Van Buuren MIND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 OqI3012021 Saskia Van Buuren MIND Communications Dispatcher iu.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fiftb Avenue, ❑ SCC SUBTOTAL$ 59.00 *Contributor Codes IND- Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 � t from 01/01/2021 • ' through 06/30/2021 page 189 of 202 NAME OF FILER 1.[]. NUMBER San Rafael Police Association Political Action Committee 831553 DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION TO DATE DATE (E COMMITTEE, ALSO I D.N OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/15/2021 Saskia Van Buuren X❑IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue Rafael CA 94901 05/31/2021 Saskia Van Buuren ElIND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avgnii­ aan R�jZnpl_ CA 94Q01 J SCC 06/15/2021 Saskia Van Buuren BIND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Auenue. San Rafael,94901 06/30/2021 Saskia Van Buuren El IND Communications Dispatcher 10.40 142.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 1/15 Lorena VegaIND + Police Officer 17.80 182. U C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 ;f ❑ SCC SUBTOTAL$ 59.40 '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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. / 601 from 01/01/2021 O through 06/30/2021 page 190 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ND CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 01/31/2021 Lorena Vega" X❑IND police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 [:]OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 02./12/2021 Lorena Vega El IND police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 02/26/2021 Lorena Vega ©IND Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, C SCC 1520 Fjf�;b Aveave. San Rafael. CA 949nj 03/15/2021 Lorena Vega E] IND Police Officer 17.80 182.14 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ElPTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 a Lorena Vega X❑IND Police Officer 13.3 C/o: San Rafael Police Association 1520 Fifth City Of San Rafael ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. S,@Ln Rafael, CA 5149DI ❑ 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$ 84.50 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period M CALIFORNIA to whole dollars./ i from U/01/2021 • through 06/30/2021 Page 191 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE ND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) T4/15/2021 Lorena VegaX❑IND Police Officer 182.10 C/o: San Rafael Police Association 1520 Fifth [-]COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San fael CA 9d 901 04/30/2021 Lorena Vega x❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM ^ity Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, IS20 F;Jth Ay -11— q— CA 94901 ❑ SCC 05/15/2021 Lorena Vega El IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY , intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael. CA 94901 05/31/2621 Lorena Vega E] IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 5 Lorena Vega RIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 rifth Avenue, San Rafael. CA 21201-- ❑ SCC 1 1 SUBTOTAL$ 66.50 "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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALAFORNIA to whole dollars. from 01/01/2021 FORM through 06/30/2021 Page 192 of 202 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 RECEIVEDHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER LD. NUMBER) CODE * CCUP TIONAND SELF-EMPLOYED, EMPLOYER OCCUPATION (JAN. 1 - DEC. 31) IF REQUIRED ( ) OF BUSINESS) 05/30/2021 Lorena VegaX❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [:]COM City Of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 01115/2021 Mark Wilkinson 91 IND Officer 17.80 182..10 C/O: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, Rafael,1520 Fifth-Ayaau, San ❑ SCC 01/31/2021 Mark Wilkinson E] IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through FIFTY intermediary: San Rafael Police Association, ❑ SCC 1 20 Fifth Avenue, �pn Rafael. 90 02/12/2021 Mark Wilkinson EIIND Officer 17.80 1$2.10 C/o: San Rafael Police Association 1520 Fifth [—]COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 b2/26/2021 Mark Wilkinson QIND 0 ricer 1 /. UU C/o: San Rafael Police Association 1520 Fifth [:] COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 949Q�__ ❑ SCC I SUBTOTAL$ 84.50 *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. / * , from 01/01/2021 � through 06/30/2021 page 193 of 202 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT THIS CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED PERIOD CALENDAR YEAR (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/15/2021 Mark WilkinsonX❑IND Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth El COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 03/3012021 Mark Wilkinson x❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 152D Fifth Avanue- 9,n Rafael, CA 94901 [-]SCC 04/15/2021 Mark Wilkinson E] IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. San Rafael, CA 94901 04/30/2021 Mark Wilkinson X❑IND Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth City of San Rafael E] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 95115/2021 inson Mar Wilkinson❑ IND Officer 1 C/o: San Rafael Police Association 1520 Fifth City of San Rafael [:] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94�01 ❑ SCC SUBTOTAL$ 71.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC -Small Contributor Committee www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. * ' from 01/01/2021 from- FORM Page 194 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER I AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO LD NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Officer 13.30 05/31/2021 Mark WilkinsonX❑IND %. . C/o: San Rafael Police Association 1520 Fifth ❑ COM City of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 Officer 13.30 182.10 06/15/2021 Mark Wilkinson 91 IND C/o: San Rafael Police Association 1520 Fifth []COM City of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, f-- San RaZaal, CA 94901 ❑ SCC 06/30/2021 MIND Officer 13.30 182.10 San Rafael Police Association 1520 Fifth ❑COM City of San Rafael [MarkWilkinson eafael, CA 94901 ❑OTH member's dues received through ❑PTY mediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael, CA 94901 01/15/2021 Ethan Welgamott MIND ❑❑ Police Officer 17.80 182.10 C/o: San Rafael Police Association 1520 Fifth COM City Of San Rafael Avenue San -Rafael, CA 94901 ❑ OTH Union member's dues received through [-]PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael CA 94901 -71/31/2021 Ethan Wp gamott MIND Police Officer 17.80 1 82,19 C/o: San Rafael Police Association 1520 FifthEl COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ 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$ 75.50I� FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT. Monetary Contributions Received Amounts may be rounded Statement covers period , to whole dollars. / ` from 01/01/2021 MR, NAME OF FILER San Rafael Police Association Political Action Committee FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 62/12/2021 Ethan WolgamottRIND Police Officer C/o: San Rafael Police Association 1520 Fifth ❑ City Of San Rafael '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 olice Officer ity Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael lice Officer ty Of San Rafael through 06/30/2021 Page 195 of 202 AMOUNT RECEIVED THIS PERIOD 17. 17.80 I.D. NUMBER 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 182.10 1 182.10 13.301 182.10 SUBTOTAL$ 80.00 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Avenue ❑ COM San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue Sari Rafael CA 94901 _ 02/2.5/2021 Ethan Wolgamott X❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 03/15/2021 Ethan Wolgamott x❑IND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue OTH San Rafael, CA 94901 ❑ Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue. A 9490 03/30/2021 Ethan Wolgamott RIND C/o: San Rafael Police Association 1520 Fifth ❑ COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael, CA 94901 '04/15/2021 Ethan Wolgamott [g] IND C/o: San Rafael Police Association 1520 Fifth F] COM Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through [-jPTY int.—r_mediary: San Rafael Police Association, , _-1 ._-__--_ .-_, n, a__i rw ew nni ❑ 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 olice Officer ity Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael lice Officer ty Of San Rafael through 06/30/2021 Page 195 of 202 AMOUNT RECEIVED THIS PERIOD 17. 17.80 I.D. NUMBER 831553 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 182.10 1 182.10 13.301 182.10 SUBTOTAL$ 80.00 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) atementcovers period Monetary Contributions Received Amounts may be roundedFfromst to whole dollars. 01/01/2021 Page 196 of 202 through 06/30/2021 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE AND ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO I.D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 04/30/2421 Ethan WolgamottX❑IND Police Officer 13.30 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue San Rafael A 94901 — 05/1.5/2021 Ethan Wolgamott MIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue ❑ OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 05/31/2021 Ethan Wolgamott ECIND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth [3 COM City Of San Rafael Avenue []OTH San Rafael, CA 94901 Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 0 Fifth Avenue. CA 94901 06/15/2021 Ethan Wolgamott X❑IND Police Officer 13.30 181-10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 []OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, ❑ SCC 1520 Fifth Avenue, San Rafael CA 94901 --06/3012021 Ethan WolgainotE X❑IND Police Officer 13.30 182.10 C/o: San Rafael Police Association 1520 Fifth ❑ COM City Of San Rafael Avenue San Rafael, CA 94901 ❑ OTH Union member's dues received through ❑ PTY intermediary: San Rafael Police Association, 1520 Fifth Ay_QjWU. Sgn Rafael- CA 94903, ❑ 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$ 66.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee Statement covers period from 01/01/2021 through 06/30/2021 page 197 of 202 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 831553 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 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER LD. NUMBER) CODE OR Donor Stack, LLC 312 Clay Street, Suite 300 Oakland, CA 94607 Donor Stack, LLC 312 Clay Street, Suite 300 Oakland, CA 94607 Donor Stack, LLC 312 Clay Street, Suite 300 Oakland, CA 94607 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 770.24 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. .............. $ 3, 663.18 2. Unitemized payments made this period of under $100......................................................................................................................-----................ $ 50.07 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e).) .............. $ 0.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 3,713.25 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE _ NAME OF FILER San Rafael Police Association Political Action Committee Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULE E Page 198 of 202 I.D. NUMBER 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/tiallot 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Donor Stack, LLC 312 Clay Street, Suite 300 Oakland, CA 94607 Donor Stack, LLC 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company 312 Clay Street Suite 300 CODE OR DESCRIPTION OF PAYMENT WEB PRO PRO Oakland, CA 94607 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.netfile.com AMOUNT PAID 152.71 94.23 169.50 884.00 102.50 SUBTOTAL $ 1,402.94 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Commit Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through: 06/30/2021 SCHEDULE E Page 199 of 202 I.D. NUMBER 831553 T. 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 F1L 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 UT campaiqn literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID S.E. Owens & Company PRO 241.50 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company PRO 1,034.50 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company PRO 214.00 312 Clay Street, Suite 300 Oakland, CA 94607 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.netfile.com SUBTOTAL $ 1,490.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule F Accrued Expenses (Unpaid Bills) S_EE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 through 06/30/2021 SCHEDULEF Page 200 of 202 I.D. NUMBER 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 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) CODE OR (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR OUTSTANDING AMOUNTINCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I D NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD j BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) I OF THIS PERIOD S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. PRO 241.501 0.001 241.501 0.00 1,034.50 102.50 SUBTOTALS $ 1,378.50$ 0.00 1,034.5 0.00 102.5 0.00 0.00 0.00$ 1,378.50$ 0.00 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.) ............................................ INCURRED TOTALS $ 719.00 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.) ............ ... PAID TOTALS $ 1,378.50 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................................................................................................ NET -659.50 May be a negative number www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov SCHEDULE F (CONT.) Schedule F (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. " M 460 Accrued Expenses (Unpaid Bills) from 01/01/2021 through- 06/30/2021 Page 201 of 202 NAME OF FILER I.D. NUMBER el 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 IVITG 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 UT 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 CREDITOR (IF COMMITTEE, ALSO ENTER LD NUMBER) S.E. Owens & Company 312 Clay Street, Suite 300 Oakland, CA 94607 (a) CODE OR OUTSTANDING DESCRIPTION OF PAYMENT BALANCE BEGINNING S.E. Owens & Company PRO 312 Clay Street, Suite 300 Oakland, CA 94607 S.E. Owens & Company PRO 312 Clay Street, Suite 300 Oakland, CA 94607 SUBTOTALS$ www.netfile.com OF THIS PERIOD 0.0 0.0 0.00 (b) (c) (d) AMOUNTINCURRED AMOUNT PAID OUTSTANDING THIS PERIOD THIS PERIOD BALANCE AT CLOSE (ALSO REPORT ON E) OF THIS PERIOD 146.50 0.00 146.50 375.00 0.00 375.00 197.50 0.00 197.50 0.00$ 719.00$ 0.00 $ 719.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash Amounts may be rounded Statement covers period to whole dollars. from 01/01/2021 SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) through 06/30/2021 DESCRIPTION OF RECEIPT Page 202 of 202 I.D. NUMBER 831553 AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0.00 Schedule I Summary 1. Itemized increases to cash this period........................................................................................................................ $ 0.00 2. Unitemized increases to cash of under $100 this period............................................................................................. $ 7.15 3. Total of all interest received this period on loans made to others. Schedule H, Column (e).) .............. $ 0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ........................................................................................................................... TOTAL $ 7.15 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com