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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 Foundation; 06-30-24COVER PAGE CoverPage SEE INSTRUCTIONS ON REVERSE Statement covers period from April 1, 2024 through Tune 30, 2024 1. Type of Recipient Committee: All Committees - Complete tarts t, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ® Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (AlsoCompiefePart 5.) O Sponsored (Also Complete Par, 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee I„Iso Coirpleta Pan n I.D. NUMBER 1467556 Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 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 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 91 1! 3 L v .= age 1 of 19 Date of election if appl - (Month, Day, Yea For Offlmai Use Only November 5, 2024 E CLERK'S OFFICE 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) Treasurer(s) NAME OF TREASURER Charles Stuckey MAILING ADDRESS 109 STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 415- OF ASSISTANT TREASURER, IF ANY Charles Litchfield MAILING ADDRESS 96 STATE ZIP CODE AREA CODE/PHONE San Rafael OPTIONAL: FAX; E-MAILADDRESS CA 94901 415- Verification I have used all reasonable diligence in preparing and reviewing this statement and 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 a Officeholder Candidate Controlled o 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. 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 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 19 NAME OF BALLOT MEASURE Revitalize San Rafael Libraries & Community Center BALLOT NO. OR LETTER JURISDICTION ® SUPPORT San Rafael ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (lan/2026) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov C%'Aampaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME orFILER Revitalize San Rafael Libraries &(ommunity Center Ad Committees top Funder San Rafael Public Library Foundatim Column Contributions Received TOTAL THIS PERIOD (FROM ATTACHED omEouLo* 1. K�onetaryContributions ----------------- �hoxumA.Lmax $ I8O20 2. Loans Received .................... —...................................... Schedule B, Line -,- 3. SUBTOTAL CASH CONTRIBUTIONS— ... .... ....... —...... Add Lines /+u $ 18020 4. Nonmon�oryCo�hbudons--------------' a�*m^e�Lmey Z0 18250 S. paymen�yWade--------------------- Schedule Line $ �� 7. Loans Made ........................ --- ..................... —.............. Schedule H. 'Lmox `, 8. SUBTOTAL CASH F�Y/K�ENT8------------- A�'Lmo6~r $ �� 3. AocmedExpenaes(UnpaidBiUe) ------------- —�F. noxou"Lmeo 1608 iU.NunmunetaryAdustman------------------- uchedule C, Line '"' 11.TOTAL EXPENDITURES MADE .... ............ ...... _— Add Lines n+o+m $ 7114 Current Cash Statement 12,Beginning Cash Balance ..................... ...... Prvxmmovmma�Line $ 1412 13.Cash Recsi�s-------------------' c�umo�m�oabo� l8O20 14.Miscellaneous Increases to Cash ... —.... ---.......... . Schedule 1. Line `' 15CaohPayments------------------- Column A, Line oabove 550" 18.ENDING CASH BALANCE ------Add Lines 12+13 ^~^mo uuom�m� ,15 $ 13926 Ifthis isstermination statement, Line 10must bozero. 17. LOAN GUARANTEES RECEIVED ............... ............... Schedule B,� p�z $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equiva|e�s---------------- see instructions on reverse $ l3926 66U# SUMMARYPAGE Statement covers period from April l,2O24 / 3 l9 ��3�l�4 through —i��----�--- Column CALENDAR YEAR TOTAL TO DATE 114053 _—___ 5000 $ 119053 ____-- 230 119283 l05l%7 'O' $ 105127 1608 -,' $ 106735 To calculate Column s. add amounts inColumn Amthe corresponding amounts from Column o nfyour last report. Some amounts inColumn xmay benegative figures that should bosubtracted from previous period amounts. If this inthe first report being filed for this calendar year, only carry over the amounts from Lines 2.7.and 9(if I.D. NUMBER 1467556 Caiendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date zoContributions Received $----------__ $ � 21Expenditures xp�n nan � Made $--________ $ Candidates 22. Cumulative Expenditures Made* (if Subject wVoluntary Expenditure Limit) Date mElection Total to Date � *Amounts inthis section may be different from amounts reported in Column B. FppCForm 46OUan/2VzGU ppPCAdvice: advica@*ppc.ca.gov(8s6/2rs-377z Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period from April 1, 2024 through June 30,2024 j Page 4 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 11467556 FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I -DEC. 31) (IF REQUIRED) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) Wq1 IND 04/01/24 Penny M. Pera El Com Retired 100 100 n/a F-1 OTH Santa Rosa, CA 94509 F-1 PTY El SCC 7 IND 04/01/24 Bert Katzung El COM Retired 100 100 n/a F-1 OTH San Rafael, CA 94901 ❑ PTY 0 SCC Z IND 04/04/24 Daniel H. Mardesich El Com Retired 100 100 n/a El OTH Greenbrae, CA 94904 El PTY El SCC 7 IND 04/04/24 Jonathan Parker r-1 Com Real Estate Developer 250 250 n/a E] OTH Monahan Parker, Inc. Kentfield, CA 94904 F-1 PTY El SCC Foll IND 04/04/24 Jeff Schoppert R COM Retired 500 1 500 n/a F] OTH San Rafael, CA 94903 F1 PTY El SCC SUBTOTAL $ 1050 Schedule A Summary Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.). . ...................................... - ................... ....... 2. Amount received this period — uniternized monetary contributions of less than $100 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)... 17850 170 *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/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT) Monetary Contributions Received to whole dollars. Statementcovers period ® . , qq from @!Z ®. through Page of NAME OF FILER I.D. NUMBER FLU t- z V_ 3-A Al L aA&[ � ��►� �� i �� m � cDot 'SPLf If 4OY S 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 05/01/24 Maribeth Bushey ❑ COM Attorney 1000 1000 n/a 396 Riviera Sftware, Inc San Rafael, CA 94901 ❑ PTY ❑ SCC IND 06/05/24 Al Boro ❑ COM Retired 250 250 n/a 274 Mountain Rafael. CA 94901 ❑ PTY ❑ SCC ❑Q IND 06/05/24 Maureen Boro El COM Retired 250 250 n/a 19 Shannon Rafael, CA 94901 ❑ PTY ❑ SCC ❑s IND 06/24/24 Jacquelyn Brand El Retired 5000 5000 n/a 312 Riviera Rafael, CA 94901 ❑ PTY ❑ SCC ❑IND 06/24/24 Friends of the San Rafael Library (501(c)(3)) ElCOM 7500 7500 n/a 1100 E Rafael, CA 94901 ❑ PTY El SCC SUBTOTAL $ 14000 "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) Amounts may be rounded SCHEDULE (CONT.) Monetary ntributionS Received to whole dollars. Statement covers period from April 1, 2024 ® - through Tune 30, 2024 Page of + NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees 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 04/04/24 Larry Andow 0 COM Retired 500 500 n/a ❑ OTH San Rafael, CA 94901 PTY ❑ SCC ®IND IND 4/12/24 Michelle Wolfe ❑ Teacher 1000 1000 n/a ❑ OTH Tuoro University -California San Rafael, CA 94915 ❑ PTY ❑ SCC ❑ IND IND 04/12/24 Barbara Heller ® COM Retired 500 1000 n/a ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC ®IND IND 04/17/24 Carin Normandin ❑ Retired 100 100 n/a ❑ OTH Rohnert Park, CA 94928 ❑ PTY ❑ SCC Q IND 04/19/24 Susie Pollak DCOM Retired 100 100 n/a ❑ OTH San Rafael, CA 94901 ❑ PTY 01 SCC SUBTOTAL $ 2200 '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)) Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from April 1, 2024 through June 30, 2024 Page L7 of I _ J-9-- NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees 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 RECEIVED THIS CALENDAR YEAR TO DATE CONTRIBUTOR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER LD. NUMBER) OF BUSINESS) PERIOD (JAN. I - DEC, 31) (IF REQUIRED) IND 06/27/24 Linda DeLucchi El COM Science Education 100 100 n/a 676 OTH Researcher Berkeley, CA 94707 E] PTY University of California E SCC 7%f IND 06/30/24 Karyn Palmer F1 COM Retired 500 500 n/a 13948 OTH Sherman Oaks, CA 94101 ❑ PTY SCC F-1 IND El COM F-1 OTH F-1 PTY ❑ SCC F-1 IND D COM ❑ OTH ❑ PTY D SCC ❑ IND El com ❑ OTH ❑ PTY El SCC SUBTOTAL$ 600 *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) NO= Schedule B Part I to whole ---' ----- — statement covers period Loans Received April 1, 2024 from — thir,,gh June 30, 2024 Page 8 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 FULLNAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT I AMOUNT PAID OUTSTANDING INTERES I ORIGINAL CUMULATIVE �CONTRIBUTIONS OFLENDER COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EPAPLOYED, ENTER BALANCE RECEIVED THIS BEGINNINGTHIS1 PERIOD OR FORGIVEN BALANCE AT PAID THIS THIS PERIOD� CLOSE OF THIS PERIOD AMOUNTOF LOAN TO DATE (IF NAME OF BUSINESS) PERIOD PERIOD PAID CALENDAR YEAR Charles Litchfield Real Estate Broker 0 5000 0 5000 5000 Litchfield Brokers RATE E] FORGIVEN i PER ELECTION San Rafael, CA 94901 PAID CALENDAR YEAR RATE FORGIVEN PER ELECTION** DATE DUE DATE INCURRED PAID CALENDAR YEAR FORGIVEN PER ELECTION� RATE 1. Loanereoeivedthinperod------------------------' (Total Column 0dplus unbemizedloans ufless than $iOOj 2. Luanmpeidorforgiventhksperod-------------------- — (Tota Column (c)plus loans under 81OOpaid orforgivenj (include loans paid byathird party that are also itemized onSchedule A`) 3. Net change this period. (Subtract Line 2from Line 1j......................... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven mpaid by another party also must be reported on Schedule A. ** If required. --.......................... ......... $ --------------$ (May be a negative number) on Schedule E, Line 3' tContributor Codes COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party FPPC Form 460(Jan/2016)) FpPCAd*ice udvce@f pc�a.gov(866/27s-3772) SCHEDULE B - PART 2 Schedule B — Part 2 Amounts may De rounaea Statement covers period to whole dollars. Loan Guarantors April 1, 2024 from Page _9 of 19 through June 30, 2024 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation a 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT BALANCE LA CONTRIBUTOR PAT M CUMULATIVE OC CU IONANDE PLOYER LOAN GUARANTEED OUTSTANDING CODE (IF SELF-EMPLOYED, ENTER THIS PERIOD TO DATE TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) LENDER 1,11LtNUIAN, YEAR F1 IND 0 0 1 0 R COM F OTH DATE PER ELECTION F-1 PTY (IF REQUIRED) 7 ScC LENDER CALENDAR YEAR E] IND 0 � 0 F com ( ❑ OTH DATE PER ELECTION F-1 PTY (IF REQUIRED) ❑ ScC CALENDARYEAR LENDER ❑ IND 0 0 D COM FIOTH PER ELECTION [_1 PTY DATE (IF REQUIRED) F-1 SCC LENDER CALENDARYEAR ❑ IND F-1 COM 0 S 0 F-1 OTH I PER ELECTION ❑PTY DATE (IF REQUIRED) E]SCC Enter on SUBTOTAL $ 0 SummaryPage, Line 17 only. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) WWWJPPC.ca.gov Schedule C Amounts, may beroundedSCHMIJI-E C Nonmonetary Contributions Received tu VMUR; statement covers period A a April 1, 2024 from 10 19 Page — of — June 30, 2024 through SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize Sap. Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 I CUMULATIVE To DATE FULL NAME, STREETADDRESSAND IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ DATE PER ELECTION CONTRIBUTORI OCCUPATION AND EMPLOYER TO DATE ZIP CODE OF CONTRIBUTOR FAIR MARKET RECEIVED I CODE* (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES CALENDAR YEAR (IF REQUIRED) VALUE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) 4/1-6/'30/ Charles Stuckey F71 IND F] COM Retired Postage 230 230 24 109 Knollwood CA 94901 [:] OTH Bookkeeping- Il []PTY Quickbooks 11 SCC F] IND M COM 0 0 n OTH E]PTY FISCC E] IND n COM 0 0 ❑ OTH ❑ PTY El SCC n IND El COM 0 0 n OTH F-1 PTY FISCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 230 1 1 Schedule C Summary 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.) .....................TOTAL $ 230 230 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 FPPC Form 460 (1an/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. A-pril 1, 2024 Reim Candidates, Measures and Committees from through June 30, 2024 I I 19 Page SEE INSTRUCTIONS ON REVERSE - of NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED, PERIOD CALENDAR YEAR TO DATE Monetary Nonmonetary Contribution Independent [I support El oppose Expenditure Monetary Nonmonetary Contribution independent El Support [I Oppose Expenditure Monetary Nonmonetary Contribution Independent El support 0 oppose Expenditure SUBTOTAL $ 1. Itemized contributions and independent expenditures made this period. (include all Schedule D subtotals.) ....... .......................... - ......... $ 2. Unbennizedcontributions and independent expenditures made this period of under $10U...... --................. ......... ...... ............................... —$ 3.Total contributions and independent expenditures made this period. (Add Lines 1and 2. Donot enter onthe Summary Page.) ..... .... TOTAL'$ FPpCForm 46uUan/2n1W) FPPC Advice: edvice@fppu.ca.go*(8u6/ars-3r72) Schedule D (Continuation Sheet) Arnounts may be rounded SCHEDULE D (CONT) Summary of Expenditures to whole dollars. Statement covers period Supporting/Opposing Other April 1, 2024 from — Candidates, Measures and Committees FPge !!ji through June 30, 2024 2 of _91 — NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 NAME OF CANDIDATE, OFFICE, AND DISTRICT OR I ESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION D DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT CALENDAR YEAR TO DATE (IF REQUIRED) PERIOD OR COMMITTEE (JAN. 1 -DEC. 31) (IF REQUIRED) Monetary i Contribution 0 0 n/a Nonmonetary Contribution E] Independent El Support El oppose Expenditure E] Monetary Contribution 0 0 n/a Nonmonetary Contribution E] independent E] Support ❑ Oppose Expenditure E] Monetary Contribution 0 0 n/a ❑ Nonmonetary Contribution Independent [I Support El oppose i Expenditure i Monetary Contribution 0 0 n/a Nonmonetary Contribution ❑ independent ❑Support oppose Expenditure SUBTOTAL $ 0 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwW.fppC.Ca'goV SCHEDULEE Schedule E SEE INSTRUCTIONS nwREVERSE Amounts may be rounded to whole dollars. Devitalize San Rafael Libraries & Community Center AdCommittees top FuoJer San Rafael Public Library Foundation Statement covers period from April l`2O24 through June 30, 2024 CODES: U one of the following codes accurately describes the payment, you may enter the code. Othanwise, describe the payment �D.wmmBEn 1467556 CMpparaphernalia/misc. MBR member communications FwD radio airtime and production costs CNG campaign consultants MT8 meetings and appearances RFD returned contributions CTB contribution (explain nonmonetap0~ OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL txurcable airtime and production costs nL candidate filing/ballot fees pHO phone banks TnC candidate travel, lodging, and meals FNo fundraising events POL polling and survey research rRn and meals |mo independent expenditure supporting/opposing others (explain)* pOS postage, delivery and messenger services T8F transfer between committees ufthe same nandidetelsponoor LEG legal defense PRO professional services (|egal.accounting) voT voter registration LIT campaign literature and mailings PRT print ads vvEe information technology costs (intemet.a'maiV NAME AND ADDRESS oFPAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Neilsen Merkhamer et al PRO 1500 2350 Kerner Blvd 94901 Olsen Petition Management, LLC Ph I signature gathering 1965 808 N. Irwin ^Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3749 Schedule E Summary 5506 i. Itemized payments made this period. (include all Schedule Enubtota|sj......... -----........ ............ -------...... —...... ....................... $ 2. Unbemized payments made this period ofunder $1OU... ............ ---.......... ............. ......... ........ ---........ ..... —....... --.......... ........ $ ' 3. Total interest paid this period onloans. (Enter amount from Schedule B. Pad 1. Column (e)l...... ___ ......... ..... ........................... ..... ___ $ ~ 4.Total payments made this period. (Add Lines 1.2.and 3.Enter here and onthe Summary Page, Column A,Line S.)........... .......... .... TOTAL $ 5506 FPPC Form 460(Jan/2O16)) FPpCAdvice: edvice@fppc.oa.gnv(86e/27s'3r72) wwwdppn.oa.gov Schedule E (ContinuationSheet) Amounts may be rounded to whole dollars. SCHEDULE E (CONT.) i Statement covers period April 1, 2024 ® > Payments from through Tune 30, 2024 sage 14 19 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation I 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 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 LID. NUMBER) eFundraising Connections Credit Card discounts on donation made by credit cards 1002 Sacramento, CA 95816 I Minuteman Press I f Printing letterhead stationery 56 , San Rafael, CA 94901 j 1 The Monaco Group i Printing ballot measure 699 Santa Ana, CA 92705 I I i I I i 0 3 I 0 1 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1757 €PPC Form 46€3 (Jan 2016)) FPPC ,advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Amounts may be rounded Statement covers period Accrued Expenses (Unpaid Bills) to whole dollars. April 1, 2024 from - NMI SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees 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 M8R member communications RAD radio airtime and production costs CmS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmnnmarA~ OFC mffiva expenses SAL oampaignmmdem'va|ahes CVC civic donations PET petition circulating TEL txo,cable airtime and production costs F|L candidate filing/ballot fees pHO phone banks TRIC candidate tl, lodging, and meals FND fundraising events P0L polling and survey research TnG staff/spouse travel, lodging, and meals |mo independent expenditure supportinglopposing others (explain)* pOa postage, delivery and messenger services TSF transfer between committees n[the same candidate/sponsor LEG legal defense PRO professional services (lega|.accounting) vOT voter registration LIT campaign literature and mailings pRT print ads VvEB information technology costs (mtemsu.e'maiV 1 NAME AND ADDRESS OF CREDITOR I CODE OR OUTSTANDING I 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 2350 Rafael, CA 94901 1011S. Ana, CA 92705 -papnemsthataeconmuutionsmmuependen expenditures must also be SUBTOTALS * 2199 $ 1608 $ 3199 $ 1008 summarized on Schedule D_ Schedule F Summary 1.Total accrued expenses incurred this period. (include all Schedule FColumn ( subtotals for 1608 accrued expenses of $100 or more, plus total uniternized accrued expenses under $100.) ...... .......... _ ......... .......... ... INCURRED TOTALS $ 2. Total accrued ex (include all Schedule F, Column (c) subtotals for payments on accrued expenses of$1O0ormore, plus total unhemizedpayments onaccrued expenses under $1OOl.'. 3 Net this Line Enter � change � mo � (591) onthe Summary Page, Column A^Line &)..... —....... ............ .......... ---'.---...... ....... .................... ...... .................... ..._........ ...................... —NET $ May be a negative ==w" FPPCForm 46O(Jan/2Vu6)} FPPC Advice: mdwice@fppc.ca.gov(866/Zr5-3772) wwm^fppo.ca.gov Schedule (Continuation Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. Statement covers period from April 1, 2024 SCHEDULE F (CONT) 1 through June 30, 2024 Page 16 of 19 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees 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 CT, B 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) l CODE OR DESCRIPTION OF PAYMENT OUTSTANDING BALANCE BEGINNING OF THIS PERIOD I (b) AMOUNT INCURRED THIS PERIOD {c) AMOUNT PAID I THIS PERIOD i (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE l OF THIS PERIOD i 0 0 0 0 j o o 0 i 0 i I 1 0 1 { SUBTOTALS $ 0 $ 0 $ 0 $ 0 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. from April 1, 2024 SCHEDULE G through June 30, 2024 1 Page. 17 of 19 SEE INSTRUCTIONS ON REVERSE I NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code CIVIP 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 PR print ads * 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) Otherwise, describe the payment. RAID 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID N R 111 It 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) www.fppc.ca.gov SCHEDULE Schedule H !amounts may be rounded Statement covers period 1 � Loans Made ' Others* to whole dollars. from April 1, 2024 page 18 of 19 through June 30, 2024 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 IFAN INDIVIDUAL, ENTER FULL NAME: STREET ADDRESS AND ZIP CODE ( OCCUPATION AND EMPLOYER (a (b) c e OUTSTANDING AMOUNT REPAYMENT OR OUTSTANDING (r ORIGINAL g CUMULATIVE OF RECIPIENT ( IF SELF-EMPLOYED, ENTER BALANCE LOANED THIS FORGIVENESS I BALANCE AT INTEREST AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) ` NAME OF BUSINESS) Pppinn BEGINNING THIS PERIOD I THIS PERIOD* PERinn CLOSE OF THIS RECEIVED I LOAN TO DATE ❑ PAID I I CALENDAR YEAR $0 i $0 0 % 1$0 $0 RATE ❑ FORGIVEN PER ELECTION** j$ 0 $ 0 i$ 0 $ 0 $ n/a I DATE DUE ( DATE INCURRED ! ❑ PAID I CALENDAR YEAR E ❑ FORGIVEN RATE PER ELECTION $0 0 $ 0 $n/a DATE INCURRED �$0 I$ I DATE DUE *Loans that are contributions to another candidate or committee must I j also be summarized on Schedule D. Loans forgiven must also be SUBTOTALS $ 0 0 $ 0 $ 0 reported on Schedule E. is (Enter (e) on 1 Schedule i, Line 3) I t 1. Loans made this period....................................................................... (Total Column (b) plus uniterrlized loans of less than $100.) 2. Payments received onloans............................................................... (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.) ............................... $ -*If Required (May be a negative number) FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppe.Ca.gov Schedule I Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. Statement covers period from April 1, 2024 — SCHEDULEI through. June 30, 2024 Page 19 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I-D. NUMBER Revitalize San Rafael Libraries & Community Center Ad Committees top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME AND ADDRESS OF SOURCE I AMOUNT OF I DESCRIPTION OF RECEIPT RE (IF COMMITTEE, ALSO ENTER J.D. NUMBER) I I INCREASE TO CASH 0 A It W W Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ o Schedule I Summary 1. Itemized increases to cash this period . ...... .................. ..................... .................................. ......... - ................... ......... $ 0 2. Unitemized increases to cash of under $100 this period . ....... ...... .................... ................... .................................. $ 0 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ...............................-......$ 0 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 0 Summary Page, Line 14.) - ................ ......... - ......... ...... ................. ........... ...... TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov