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Home My WebLink AboutForm 460 - Revitalize San Rafael Libraries and Community Center Ad Committee's Top Funder San Rafael Public Library Foundations s. - •. • - r - • _- SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/24 through 03/31/24 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ® Primarily Formed Ballot Measure O State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's top funder San Rafael Public Library Foundation 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 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94912 OPTIONAL: FAX / E-MAIL ADDRESS CALIFORNIA 00 n r^ L� Page 1 of 19 Date of election if a a le: (Month, Day, ar) For Official Use Only r November 5, 20 ' CITY CLERKS OFFICE ❑ Preelection Statement F71 Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) NAME OF TREASURER Charles H. Stuckey MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY Charles Litchfield MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael OPTIONAL: FAX / E-MAIL ADDRESS CA 94901 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury .under the laws of the State of California that the Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460(3an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO-ANDSTREET) 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES E] NO COMMITTEE ADDRESS STREETAIDDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [—] YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of 19 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Revitalize San Rafael Libraries and Community Center ad Commitee's Top Funded BALLOT NO. OR LETTER JURISDICTION I San Rafael ®SUPPORT M OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnames of officeholder(s) or candidate(s) for which this committee is primarily formed NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT E:1 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD El SUPPORT Ej OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS owREVERSE NAME opFILER Revitalize San Rafael Libraries &Communitv Center AdCommittee's TmFunderSan Rafael Public Library Foundation Column Contributions Received TOTAL THIS PERIOD (FROM ATTACHED nnoEDvLEn 1. K�one1oryConUibu�una----------------- oo�^m�A.Lmox $ 9�V}� 2. Loans Received ---------------------. m�ouu��Lmex 5V0O 1 SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines I+x $ 101833 4. NonmonetaryContribudnns .--------------. Schedule C, Line 101033 O. Peymen�K8ude--------------------- n�ed��cmo4 $ 99d2l 7. Loans Made ........ ...... ............................. __-.......... Schedule uLine 3 8. SUBTOTAL CASH PAYMENTS ..... ........................ ........ Add Lines o~r $ 99621 0. AnomedExpenses (Unpaid B0o--------------o�ouu��Lmno 2l99 1[LNonmunotaryAdjustment ......................................................... Schedule C. Line 101820 12.Beginning Cash Balanoe.......................... Previous Summary mm puoo�o $ 0 13.Cash Reue�o-------------------' mmmm�Lmoxauu� 1010�3 14.Miscellaneous Increases 0oCash .................................. Schedule 1,Line 4 15.Cash Peyme�s------------------- onmmn�Lmou�o� 99uzl 18.GWD{NG CASH BALANCE .................. Add Lines 12~m�then subtract $ 1412 ffthis matermination statement, Line /nmust bezero. 17. LOAN GUARANTEES RECEIVED ..... ......................... Schedule B, Pall $ Cash Equivalents and Outstanding Debts 7199 Column o^LEmDAR,s^e TOTAL TO DATE 96033 5000 $ 101033 $ 101033 _____ 99621 ' 990%l ____ 2199 $ 101820 �� Tucalculate Column e\ add amounts mColumn xtothe corresponding amounts from Column g ufyour last report. some � amounts inColumn xmay � »enegative fiyuresthat should uesubtracted from � previous period amounts. If this isthe first report being � filed for this calendar year, � only carry over the amounts � from Uneau. 7. and 8 (if SUMMARYPAGE Statement covers period from Ol/Ol/24 / 3 l9 through �8l/� | ��---�__'I.D. NUMBER ooContribmvns Received $_____-_--- $ | e1. Expenditures | Made $-_____-___ $ Candidates oa Cumulative Expenditures Made* (If Subject mVoluntary Expenditure Limit) Date orElection Total ozDate | Amounts in this section may be different from amounts reported in Column B. FppCForm 46DUao/2n1*} FPPC«dvice: (866/275-3772) Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to wnow dollars. Statement covers period ®- , from 01/01/24 ® - through 03/31/24 Page 4 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center, Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE Y (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND Various San Rafael Public Library Foundation 1467937 ® COM 89313 89313 n/a ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ® IND 03/12/24 David Layne ❑ COM Retired 50. 50. n/a ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC ® IND 03/12/24 Sarah Forsman ❑ COM Retired 25. 25 n/a ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC V IND 03/12/24 Marlene J. Casissa El Retired 20. 20.. n/a I ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC ® IND 03/19/24 Pam Dixon ❑ COM Retired 500. 500. n/a ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 89908 1. Amount received this period — itemized monetary contributions. 96033.00 (include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)................ TOTAL $ 96033.00 *Contributor Codes 1 IND — Individual 1 COM — Recipient Committee i (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) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from01/01/24 so= through 03131/24 Page 5 of 19 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR * RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND 03/19/24 Dr. Michael Parrett El COM Dentist 25 25 ❑ OTH Dr. Michael Parrett San Rafael, CA 94901 ❑ PTY ❑ SCC ® IND 03/19/24 Charles Litchfield ❑ COM Real Estate Broker 1000 1000 ❑ OTH Litchfield Brokers San Rafael, CA 9901 ❑ PTY Ej SCC ®IND 03/19/24 Kate Colin El COM Mayor 1000 1000 ❑ OTH City of San Rafael San Rafael, CA 9901 ❑ PTY El SCC ®IND 03/18/24 Joseph O'Hehir El COM Retired 1000 1000 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ®IND 03/19/24 Gary Ragghianti ❑ COM Attorney 1000 1000 ❑ OTH Ragghianti, Freitas, LLP San Rafael, CA 94901 ❑ PTY El SCC SUBTOTAL $ 4025 *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 (Dan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Deceived to whole dollars. Statement covers period ® from 01/01/24 ! - through 03131/24 Page 6 of 19 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center, Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR * RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER LD. NUMBER) OF BUSINESS) I PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND 03/19/24 Cheryl Lentini ❑ COM Architect 500 500 ❑ OTH C.A. Lentini Design San Rafael, CA 94901 ❑ PTY ❑ SCC ®IND 03/20/24 Barbara Squires El COM Administrative Asst. 100 100 ❑ OTH The Busy B Greenbrae, CA 94904 ❑ PTY ❑ SCC ®IND 03/27/24 Charles H. Stuckey El COM Retired 1000 i000 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ®IND 02/07/24 Barbara Heller El COM Retired 500 500 ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC ® IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 2100 "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 n» ...,sr k ..,...,.ateA SCHEDULE B - PART 1 Schedule B — Part 1 Loans Received to whole dollars. ~vµ Statement covers period from 01/01/24 o • - SEE INSTRUCTIONS ON REVERSE through 03/31/24 Page 7 of 19 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER ( IF SELF-EMPLOYED, ENTER OF BUSINESS) a ) c e OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS BEGINNING THISNAME PERIOD PERIOD THIS PERIOD * CLOPERIOD HIS PERIOD ORIGINAL AMOUNT OF LOAN g CUMULATIVE CONTRIBUTIONS TO DATE ❑ PAID CALENDAR YEAR Charles Litchfield Real Estate Broker $ 0 $ 5000 0 $ 5000 $ 6000 ❑ FORGIVEN $ 0 PER ELECTION * $ n/a San Rafael, CA 94901 Litchfield Brokers 0 $ 5000 $ 12/31/24 RATE $ 0 03/26/24 DATE DUE DATE INCURRED T ® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION** RATE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ S $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION" RATE t ❑ IND ElCOM [IOTH [IPTY ElSCC $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ 5000 $ 0 $ 5000 $ 0 1. Loans received this period.............................................................................. (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period................................................................... (Total Column (c) plus loans under $100 paid or forgiven.) (include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.)................................. Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. ...................................... $ ...................................... $ 5000 .... NET $ 5000 (May be a negative number) (Enter (a) on Schedule E, Line 3) tContributor 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 (!an/2036)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 Schedule B _ Part 2 Amounts may De rounaea Statement covers period to whole dollars. Loan Guarantors 01/01/24 s from through 03/31/24 Page 8 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT BALANCE OCCUPATION AND EMPLOYER CUMULATIVE CONTRIBUTOR LOAN GUARANTEED E OUTSTANDING CODE (IF SELF-EMPLOYED, ENTER THIS PERIOD TO DATE TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) LENDER CALENDAR YEAR None ❑ IND 0 0 0 ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑IND 0 0 0 ❑ COM s ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC g CALENDAR YEAR LENDER ❑ IND 0 0 0 ❑ COM ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC LENDER CALENDAR YEAR ❑ IND 0 ❑ COM 0 $ 0 ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC y Enter on SUBTOTAL $ 0 Summary Page, Line 17 only. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Rr°ltarI1 ol0 (a Amounts may be rounded SCHEDULE C ®tIIP onetary Contributions Received t® WnVoe uV':dam. Statement covers period ®I_ from 01/01/24 ® - through 03/31/24 9 page of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 FULL NAMESTREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT! CUMULATIVE TO PER ELECTION , DATE CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF DATE FAIR MARKET TO DATE ZIP CODE OF CONTRIBUTOR RECEIVED CODE (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (IF REQUIRED) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) ❑ IND None ❑ COM n/a ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM n/a ❑ OTH ❑ PTY ❑ SCC ❑ IND n/a ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM n/a ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule C Summery 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ........................................ .............................................................................. $ 2. Amount received this period — uniternized nonmonetary contributions of less than $100 ................ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) .... 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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period Supporting/Opposing Other to whole dollars. 01/01/24 Candidates, Measures and Committees from through 03/31/24 page 10 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE JAN. 1 -DEC. 31 (IF REQUIRED) () ❑ Monetary None Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 0 -♦ i 1. Itemized contributions and independent expenditures made this period. (include all Schedule D subtotals.)..................................................... 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................. 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL 0 0 $ 0 FPPC Form 460 (Jan/2016)y FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwJppc.ca.gov Schedule D j%-PUllLl11Ut1LIU11 Q11VICIL) Amounts May De rounueo SCHEDULE D (CONT.) Summary of Expenditures to whole dollars. Statement covers period Supporting/Opposing Other 01/01/24 0 from Candidates, Measures and Committees through 03/31/24 19 Page Of NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN. 1 -DEC. 31) (IF REQUIRED) E] Monetary Contribution 0 0 n/a rl Nonmonetary Contribution E] independent ❑ Support ❑ Oppose Expenditure F1 Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ Independent El support El oppose Expenditure ❑ Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ independent El Support 13 Oppose Expenditure rl Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution ❑ Independent El Support 11 Oppose Expenditure SUBTOTAL $ 0 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation Statement covers period from 01/01/24 through 03/31/24 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E :ALIFQKNIA 4 V FORM V V P �� , I,D. NUMBER 1467556 CMP campaign paraphernalia/misc. MBR member communications RAID 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) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) California Secretary of State FIL 50, Sacramento, CA 95814 Neilsen Merkhamer et a1 PRO 11765.00 San Rafael, CA 94901 Olsen Petition Management, LLC PET Signature gathering to put measure on ballot 75000.00 Hanford, CA 93230 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 86815.00 1. Itemized payments made this period. (Include all Schedule E subtotals.) ........................................... 2. Unitemized payments made this period of under$100.............................................................................................................................. 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)................................................................. 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... 99621 ............ $ ............ $ 0 ............ $ 0 TOTAL $ 99621 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule (Continuation Sheet) Amounts may be rounded to whole dollars. SCHEDULE E (CONT.) Statement covers period , •Paymentsade m 01/01/24i ffrom through 03/31/24 Page 13 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Team CivX CNS 5000 Orinda, CA 9563 eFundraising Connections Credit Card discounts on donation made by credit cards 171 Sacramento, CA 95816 The Monaco Group Printing 285 Santa Ana, CA 92705 I San Francisco Edit Proofreading 1381 San Francisco, CA 9109 Autumn Press Printing Envelopes 2934 Berkeley, CA 94710 I * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 12340 FPPC Form 460 (Jan 2016)) FPPC Advice. advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule t • Payments • Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation COGS: If one of the following codes accurately describes the CMP campaign paraphernalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)' OFC CVC civic donations PET FIL candidate filing/ballot fees PHO FND fundraising events POL IND independent expenditure supporting/opposing others (explain)" POS LEG legal defense PRO LIT campaign literature and mailings PRT payment, you may enter the code member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads itement covers 01/01/24 from through 03/31/24 Otherwise, describe the payment. SCHEDULE E (CONT.) Page 14 of 19 I.D. NUMBER 167556 RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER LD, NUMBER) United States Postal Service Post Office Box 388 San Rafael, CA 94901 Deluxe Check Printing Checks 28 Bank of Mann San Rafael, CA 94901 Internal Revenue Service Filing under 501(c)(4) 50 Cinncinnati, OH 45999-0023 0 0 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 466 FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule r •--• to whole dollars. Accrued Expenses (Unpaid SEE INSTRUCTIONS ON REVERSE NAME OF FILER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads Statement covers period from 01/01/24 through 03/31/24 Otherwise, describe the payment. Page 15 of 19 I.D. NUMBER 1467556 RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Neilsen Merkharner et al PRO 0 1500 0 1500 San Rafael, CA 94901 The Monaco Group Printing 0 699 0 699 Santa Ana, CA 92705 I * Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ 2198.62 $ 0 $ 2199 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 2199 accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 0 accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.).................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 2199 on the Summary Page, Column A, Line 9.)............................................................................................ ., ... ............. NET $ May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule (Continuation Accrued Expenses (Unpaid Amounts may be rounded to whole dollars. Statement covers period from 01/01/24 SCHEDULE F (CONT.) l through 03/31/24 Page 16 of 19 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (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 I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (h) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SUBTOTALS $ 0 $ 0 $ 0 $ 0 FPPC Form 460 (3an/2026)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 6-.N ro-W-W SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded statement covers perioa Contractor (on Behalf of This Committee) to whole dollars. from 01/01/24 J" 03/31/24 1719 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 NAME OF AGENT OR INDEPENDENT CONTRACTOR None CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL tv. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 0 0 0 0 Attach additional information an appropriately labeled continuation sheets. TOTAL* $ o * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (Jan/2016)) independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period � ®- to whole dollars. , 01/01/24 - LoanS Made to Others* from A F through 03/31/24 Page 18 of 1 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 IF AN INDIVIDUAL, ENTER FULL NAME, STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER ta) OUTSTANDING AMOUNT c REPAYMENT OR OUTSTANDING e ( ORIGINAL S CUMULATIVE OF RECIPIENT (IF SELF-EMPLOYED, ENTER BALANCE LOANED THIS BEGINNING THIS FORGIVENESS BALANCE AT CLOSE OF THIS INTEREST RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD FRIODNone❑ THIS PERIOD* pFRIon LOAN TO DATE PAID CALENDARYEAR $ 0 $ 0 $ 0 $0 r RATE FORGIVEN PER ELECTION" 0 $ 0 $ $° $0 $ DATE DUE DATE INCURRED PAID CALENDAR YEAR $ 0 $ 0 % $ 0 $ 0 RATE ❑ FORGIVEN PER ELECTION 0 $ 0 $ I$0 $0 $ DATE DUE DATE INCURRED `Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ 0 $ 0 $ 0 $ 0 (Enter (e) on Schedule I, Line 3) 1. Loans made this period.................................................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans............................................................................ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.)..................................... (Enter the net here and on the Summary Page, Column A, Line 7.) 0 ........................................................$ — 0 ...........................................................$ — .............. NET $ 0 (May be a negative number) *If Required FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) waww.fppc.ca.gov SCHFDULFI Miscellaneous Increases to Cash to whole dollars. statement covers period 01/01 /24 " from through 03/3I/24 Page 19 of 19 9 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF DESCRIPTION OF RECEIPT RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) INCREASE TO CASH none 0 0 0 0 0 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule ummary 1. Itemized increases to cash this period . ........................................... ................................................................................ $ 0 2. Unitemized increases to cash of under $100 this period....................................................... ............ ............ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ..................... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.)........................................................................................................................ ...........$ 0 0 $— FPPC Form 460 (Jan/2036)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov