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HomeMy WebLinkAboutForm 460 - San Rafael Public Library Foundation (501(c)(3))COVER PAGE 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 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (AtsoComplete Part 7) I.D. NUMBER San Rafael Public Library Foundation(NonProfit 501(c)(3)) STREET ADDRESS (NO P.O. BOX) 109 STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 415- ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX Same CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS E Date of election if I)c(�ble: (Month, Day, j FORM For Official Use Only November 5, 20 4 C I LERKs 2. Type of Statement: ❑ Preelection Statement ® 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 109 STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 415- OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS chuckstuckev@hotmail. Verification I have used all reasonable diligence in preparing and reviewing this statement and Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov MURIM11011 y i C •_ 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.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. i I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (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) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 18 M.FAI-7r ' • NAME OF BALLOT MEASURE Revitalize San Rafael Libraries & Community Center BALLOT NO. OR LETTER JURISDICTION ® SUPPORT San Rafael I n nppr)Cr 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 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/ 2036) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wrwrwr.fppc.ca.gov Ca ai n Diseloslure Statement Amounts may rounded p g to whole dollars. lars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Public Library Foundation (Nan -Profit, 501(c)(3)) Column A Contributions Received TOTAL THIS PERIOD (FR,ONI ATTACHED SCHEDULES) 1. Monetary Contributions. ... ...................... ................ . Schedule A, Line 3 $ 89313 0 2. Loans Received................................................................ Schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 +2 $ 89313 0 4. Nonmonetary Contributions .......................... .................. Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .......... ...................... Add Lines 3+4 $ 89313 ! - 1 4 I - 6. Payments Made................................................................ Schedule E Line 4 $ 89313 7. Loans Made ................................................ Schedule N, Line 3 0 8. SUBTOTAL CASH PAYMENTS.. ................... ....... - ........ Add Lines 6+7 $ 89313 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 10. Nonmonetary Adjustment ..... ................. .................................. Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 89313 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 0 13. Cash Receipts ............. .......................... .............. .----- Column A, Line 3 above 89313 14. Miscellaneous Increases to Cash .................................. Schedule t, Line 4 0 15. Cash Payments... ...... ....... .................... ...... Column A, Line o" above 89313 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B. Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ............................................... See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column a above $ 0 SUMMARY PAGE Statement covers period from 01 /01 /24 through 03/31/24 Page 3 of 18 Column B CALENDAR YEAR TOTAL TO DATE $ 89313 0 $ 89313 0 $ 89313 $ 89313 0 $ 89313 0 0 $ 89313 To calculate Column B, add amounts in Column Ato 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). I.D. NUMBER 1467937 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/ddlyy) `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 Schedule SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) FULL NAME, STREET ADDRESS AND ZIP CODE OF DATE CONTRIBUTOR RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) 12/01/23 Jane W. Evans LIFO Mill Valley, CA 94942-1925 01/26/24 Wells Fargo Advisors LIFO St. Louis, MO 93103 01/26/24 Michael Franklin LIFO San Rafael, CA 94901 01/26/24 Lee Gottshall -Maxon LIFO i San Rafael, CA 94903 01/26/24 Elizabeth Stacy LIFO San Rafael, CA 9903 Amounts may be rounded SCHEDULE A to whole dollars. Statement covers period from O1/01/24 s ® - through 03/31/24 Page 4 of 18 IF AN INDIVIDUAL, ENTER AMOUNT CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CODE * {IF SELF-EMPLOYED. ENTER PIANIE OF BUSINESS PERIOD ZI IND ❑ COM Retired 1000 ❑ OTH ❑ PTY SCC 17, IND COM Unidentifed Individuals 7000 ❑ OTH ❑ PTY ❑ SCC IND ❑ COM Retired 1000 ❑ OTH ❑ PTY ❑ SCC J IND ❑ COM Attorney 2000 ❑ OTH Allen, Malcins, et al ❑ PTY ❑ SCC ❑� IND ❑ COM Retired 1000 ❑ OTH ❑ PTY n SCC SUBTOTAL $ 12000 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 89313 (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 0 3. Total monetary contributions received this period. 89313 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.). ..................... TOTAL $ I.D. NUMBER 1467937 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1- DEC. 31) (IF REQUIRED) 1000 i n/a 1 7000 n/a 1000 n/a 2000 n/a 1000 n/a "Contributor Codes i 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 Amounts may be rounded SCHEDULE (CONT.) to whole dollars. Statement covers period F_ 01/01/24 E F# z'... 13 through 03/31/24 Page 5 of 18 NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501 (c)(3)) 1467937 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE CONTRIBUTOR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE,ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Z IND 01/26/24 Jane W. Evans LIFO El COM Retired 4000 4000 n/a F-1 OTH Mill Valley, CA 9942-1925 F-1 PTY El SCC Z IND 01/26/24 Celeste Craemer LIFO D COM Retired 1000 1000 n/a [I OTH San Rafael, CA 94901 El PTY D SCC W IND 01/26/24 Estate of William Schwarzer LIFO El com Deceased 14000 174610 n/a [] OTH San Rafael, CA 94903 E] PTY El SCC Z IND 03/05/24 Estate of William Schwarzer LIFO El COM Deceased 15000 174610 n/a n OTH San Rafael, CA 94903 0 PTY El SCC F7 IND 03/07/24 Estate of William Schwarzer LIFO El COM Deceased 30000 174610 n/a E] OTH San Rafael, CA 94903 n PTY El SCC SUBTOTAL$ 64000 *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 FPFC Form 460 (Jan/2026)) FPPC Advice., advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period Afrom 01/01/24 IB through 03/31/24 page 6 of 18 NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 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 03/25/24 Estate of William Schwarzer LIFO COM Deceased 13313 174610 ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC El IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 13313 *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 (8661275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 A A, I8 U➢BW ....9 .. --- to whole dollars. Statement covers period Loans Received from 01/01/24 ® _ through 03/31/24 Page 7 Dill8 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a O OUTSG AMOUNT c AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL 9 OF ENDER OCCUPATION AND EMPLOYER RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER F.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD CLOSE OF THIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD ❑ PAID CALENDAR YEAR None $ $ % s $ RATE ❑ FORGIVEN PER ELECTION** $ $ $ $ $ DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR $ % $ $ ❑ FORGIVEN PER ELECTION** RATE $ $ DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR $ $ % $ g ❑ FORGIVEN PER ELECTION'* RATE DATE DUE DATE INCURRED t ❑ IND ❑ COM [I OTH El PTY ❑ SCC SUBTOTALS $ 0 $ 0 $ 0 $ 0 Schedule B Summary 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.).............................................................. NET $ 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. 0 0 0 (May be a negative number) �CiltCl IGf UII JUIIGUUfC �, �Illc .�) #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 B - PART 2 Amounts may ae rounaea SC�e��U�g r Part 2 to whole dollars. - Statement covers period ®- Loan Guarantors 01/01/24 from 03/31/24 8 18 SEE INSTRUCTIONS ON REVERSE throw h g Page of NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE BALANCE OCCUPATIONANDEMPLOYER LOAN GUARANTEED OUTSTANDING CONTRIBUTOR 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 ❑ COM ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (1F REQUIRED) ❑ SCC g CALENDAR YEAR LENDER © IND ❑ COM ❑ ®TH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC 5 LENDER CALENDAR YEAR ❑ IND ❑ COM ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC s 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 Sr$ Mililp C Amounts may be rounded SCHEOULF C LU wilule UUemars. ®nmonetary Contributions Received statement covers period . - 01/01/24 from • - through 03/31/24 Page 9 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT/ CUMULATIVE TO PER ELECTION DATE CONTRIBUTOR OCCUPATIONAND EMPLOYER DESCRIPTION OF DATE TO DATE ZIP CODE OF CONTRIBUTOR ,e FAIR MARKET 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 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule C Summary 1, Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 0 2. Amount received this period — unitemized 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.).....................TOTAL $ 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 (!an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov t!-MMAs1l7iar7 Summary of Expenditures Amounts may be rounded Statement covers period Supporting/Opposing ther to whole dollars. 01/01/24 me= from Candidates, Measures and Committees through 03/31/24 Page 10 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 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 12/01/23 Revitalize San Rafael Libraries & Community Ctr Contribution 1000 89313 Ad Committee's Top Funder San Rafael Public ❑ Nonmonetary Library Foundation 1467556 Contribution ❑ Independent ® Support ❑ Oppose Expenditure ® Monetary 01/26/24 Revitalize San Rafael Libraries & Community Ctr Contribution 30000 1 89313 Ad Committee's Top Funder San Rafael Public ® Nonmonetary Library Foundation 1467556 Contribution IM ® independent Support ❑ Oppose Expenditure Monetary 03/05/24 Revitalize San Rafael Libraries & Community Ctr Contribution 15000 89313 Ad Committee's Top Funder San Rafael Public ® Nonmonetary Library Foundation 1467556 Contribution IM �. ® Independent ® Support ❑ Oppose Expenditure SUBTOTAL $ 46000 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.) ..... 89313 $ 0 TOTAL.. $ 89313 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D (Continuation Sheet) Amounts may be rounded SCHEDULE D (CONT.) to whole dollars. Summary of Expenditures Statement covers period RNM I 0 W A Supporting/Opposing Other 01/01/24 • from Candidates, Measures and Committees " 77 through 03/31/24 Of 18 7D NAME OF FILER I I NUMBER San Rafael Public Library Foundation (Non -Profit, 501 (c)(3)) 1467937 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS LIMULATIVE 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 03/07/24 Revitalize San Rafael Libraries & Community Ctr Contribution 30000 89313 Ad Committee's Top Funder San Rafael Public Nonmonetary Library Foundation 1467556 Contribution ❑ Independent Support ❑ Oppose Expenditure Monetary 03/25/24 Revitalize San Rafael Libraries & Community Ctr Contribution 13313 89313 Ad Committee's Top Funder San Rafael Public ❑ Nonmonetary Library Foundation 1467556 Contribution Independent [Z Support El oppose Expenditure 0 Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent 0 support El Oppose Expenditure Il Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ oppose Expenditure SUBTOTAL $ 43313 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period to whole dollars. Payments Made from 01/01/24 through 03/31/24 Page 12 ®f 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernaiialmisc. 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 candidatelsponsor 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) Revitalize San Rafael Libraries & Community Center Ad Committee's Top Funder Contribution to Campaign 89313 San Rafael Public Library Foundation 1467556 San Rafael, f A ­1 13 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 89313 1. Itemized payments made this period. (include all Schedule E subtotals.)............................................................................................................. $ 89333 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 89313 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwanr.fppc.ca.gov Schedule E Amounts may be rounded 1/01/24 (Continuation Sheet) to whole dollars. Statement0covers period Payments Made from l/0l/ SEE INSTRUCTIONS ON REVERSE through 03/31/24 NAME OF FILER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, CMP campaign paraphemalia/misc. MBR member communications RAD CNS campaign consultants MTG meetings and appearances RFD CTB contribution (explain nonmonetary)* OFC office expenses SAL CVC civic donations PET petition circulating TEL FIL candidate filing/ballot fees PHO phone banks TRC FND fundraising events POL polling and survey research TRS IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF LEG legal defense PRO professional services (legal, accounting) VOT LIT campaign literature and mailings PRT print ads WEE NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) describe the payment. SCHEDULE E (CONT.) Page 13 of 18 I.D. NUMBER 1467937 radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staffispouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) CODE OR DESCRIPTION OF PAYMENT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ AMOUNT PAID FPPC Form 460 (Jan 2016) FPPC Advice: adviice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F Amounts may be round Accrued Expenses (Unpaid Bills) to whole dollars. i SEE INSTRUCTIONS omREVERSE NAME mrFILER San Rafael Public Library Foundation [Noo-Profit 501(c)(3)) CODES: If one of the following codes accurately describes the payment, you may enter the code CMP MBR member communications cw8 campaign consultantsMTs meetings and appearances CTe contribution (explain npnmvnetery)~ orC omor expenses cvc civic donations PET petition circulating r|L candidate filing/ballot fees pHo phone banks Fmo fundraising events PoL polling and survey research |wo independent expenditure supportinglopposing others (explain)* pOS postage, delivery and messenger services LEG legal defense PRO professional services (l*ga|.accounting) LIT campaign literature and mailings PRT print ads Statement covers period from 0l/0l/24 03/ l/24 throu~h___-__- � Otherwise, describe the payment. SCHEDULEF 14 18 ��_�__ /.o.wumoEn 1467937 RAD radio airtime and production costs npo returned contributions GAL campaign workers' salaries TEL txo,cable airtime and production costs TRo candidatetravel, lodging, and meals Tna staff/spouse travel, lodging, and meals TGp transfer between committees ofthe same candidate/sponsor vOr voter registration vmEa information technology costs (imemat.e-maU) 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 None ~ Payments that are contributions orindependent expenditures must also be SUBTOTALS $ 0 $0 $ O $ 8 summarized on Schedule D. Schedule F Summary 1.Tbtal accrued expenses incurred this period. (include all Schedule FColumn subtotals for accrued expenses of $100 or more, plus total uniternized accrued expenses under $100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (include all Schedule F Column bjsubtotals for payments on accrued expenses of $ 100 or more, plus total uniternized payments on accrued expenses under $100.) .................................. PAID TOTALS $ 111 � � 3. Net change this . Line 2from Line 1. Enter the difference here and 0 onthe Summary Page, Column A`Line Ql.'_-....... ............................ ................. ........... ......................................................... ........................................ NET $ May be"negative number FppcForm 4eoUao/o01eD ppPcAdvice: advice@fppc'ca.gpv(86o/z7s-3rrz www.fppc.ca.anv Schedule (Continuation Accrued Expenses•. • Amounts may be rounded to whole dollars. Statement covers period from 01/01/24 SCHEDULE F (CONT.) through 03/31/24 Page 15 of 18 NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 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 staffispouse 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 LD. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD None I SUBTOTALS OTALS $ 0 $ 0 $ 0 $ 0 FPPC Form 460 (!an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period Contractor (on Behalf of This Committee) to whole dollars. from 01/01/24 Him through 03/31/24 Page 16 — of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501 (c) (3)) 1467937 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 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 supportinglopposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID None Attach additional information on 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) wvm.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period Loans Made t® Others* to whole dollars. from 01/01/24 ® . through 03/31/24 page 17 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I,D. NUMBER San Rafael Public Library Foundation (Non -Profit, 501(c)(3)) 1467937 IF AN INDIVIDUAL, ENTER FULL NAME, STREETADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER a OUTSTANDING AMOUNT c REPAYMENT OR OUTSTANDING e ORIGINAL 9 CUMULATIVE OF RECIPIENT (IF SELF-EMPLOYED, ENTER BALANCE LOANED BEGINNING THIS FORGIVENESS BALANCE AT CLOSE OF THIS INTEREST RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD D PRIOU[] THIS PERIOD* PERJQQ LOAN TO DATE PAID CALENDAR YEAR None i s $ % $ s RATE ❑ FORGIVEN PER ELECTION * $ $ $ $ $ DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION RATE $ $ 5 $ $ 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) 4 ! J 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 ..................................... I ....... $ 0 ..................................................................... NET $ 0 (May be a negative number) **If Required FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Attach additional information onappropriately labeled continuation sheets. SUBTOlAL* O 0 2. Undem�ed increases to osah ofunder $18Oth� period --------------------------------$ 3.Total ofall interest received this period onloans made bnothers. (Schedule H.Column (e)j -------------$ ` 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the O Summary Paga, Line 14.) -----------------------------------------' TOTAL $ rppCForm 46V(Jan/nuu6)) FPpcAdvice: advice@fppc�a.onv(86o/z7s-3z72