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Home My WebLink AboutForm 460 - Rachel Kertz for City Council 2024; preelectionRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2024 through 09/21/2024 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ State Candidate Election Committee ❑ Recall (Also Complete Part 5) ❑ General Purpose Committee ❑ Sponsored ❑ Small Contributor Committee ❑ Political Party/Central Committee 3. Committee Information ❑ Primarily Formed Ballot Measure Committee ❑ Controlled ❑ Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1473447 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94945 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS v i v'= %{3, Date of election if appli (Month, Day, Year) COVER PAGE I of -!- Official Use Only 11/05/2024t i 2. Type of Statement: 0 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 Tamara Hull MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94945 NAME OF ASSISTANT TREASURER, IF ANY n/a MAILING ADDRE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 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. certify under penalty of perjury under the laws of the State of California that the foregoing is trand" correct Executed on By . 9/26/24 / .�� Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent By 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 Recipient Committee Campaign Statement Cover Page ® Part 2 6. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Rachel Kertz OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council, City of San Rafael, District 4 RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP Novato CA 94945 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. NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? 1 ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADD CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of it 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7, primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign DISC!®Sure Statement Amounts may be rounded to whole dollars. Summary Page Statement covers period from 07/01/2024 SUMMARY PAGE 09/21/2024 Page 3 of f� SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Dunning in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 7,265.00 $ 14,180.00 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 0 0 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 7,265.00 $ 14,180.00 $ 20. Contributions 6,915.00 7,265.00 Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 0 21. Expenditures 183.29 3,925.99 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 7,265.00 $ 14,180.00 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 3,925.99 $ 4,109.28 7. Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 3,925.99 $ 4,109.28 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 0 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE...............:....................Add Lines 8+9+10 $ 3,925.99 $ 4,109.28 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 6,731.71 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 7,265.00 add amounts in Column 0 Ato the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line s above -3,925.99 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 10,070.72 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part $ 0 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if 0 y). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) I *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 A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA I ' from 07/01/2024 - . through 09/21/2024 Page 4 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 FULL NAME, STREET ADDRESS AND ZIP CODE OF [FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 7/1/24 Ross Guehring ❑✓ IND Consultant 225.00 225.00 225.00 ❑ COM ❑ OTH Self Novato, CA 94947 ❑ PTY ❑ SCC 7/1/24 Lora Levin ❑I IND Retired 250.00 250.00 250.00 El COM ❑ OTH Napa, CA 94558 ❑ PTY ❑ SCC 7/1/24 Julie Sherman ❑d IND Retired 100.00 100.00 100.00 ❑ COM ❑ OTH Petaluma, CA 94954 ❑ PTY ❑ SCC 7/1/24 Julie Fingersh © IND Writer 100.00 100.00 100.00 ❑ COM ❑ OTH Self San Rafael, CA 94903 ❑ PTY ❑ SCC 7/3/24 NatuTuatagaloa ZIND Consultant 250.00 250.00 250.00 El COM ❑ OTH yp P Wh s eo le LLC San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 925.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (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.).... 6,775.00 $ 490.00 ....TOTAL $ 7,265.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (1an/2016)) 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 �CALIFO. ' from 07/01/2024 s through 09/21/2024 Page 5 of i NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 7/6/24 Judith Bloomberg IND None 100.00 100.00 100.00 El COM ❑ OTH San Rafael, CA 94915 ❑ PTY ❑ SCC 7/11/24 Barbara Heller Z IND Retired 100.00 100.00 100.00 El COM ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 7/21/24 Cathryn Hilliard 0 IND Retired 250.00 400.00 400.00 ❑ COM ❑ OTH Mill Valley, CA 94941 ❑ PTY ❑ SCC 8/4/24 Matthew Samson Z IND Firefighter 1,000.00 1,000.00 1,000.00 ❑ COM ❑ OTH City of South San Francisco San Rafael, CA 94903 ❑ PTY ❑ SCC 8/7/24 Daryoush Davidi ® IND CEO 250.00 250.00 250.00 ❑ COM ❑ OTH United with Earth San Rafael, CA 94901 ❑ PTY Ll SCC SUBTOTAL $ 1,700.00 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA I t from 07/01/2024 • - through 09/21/2024 j Page 6 of NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 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) 8/18/24 Keli Honsberger ® IND Fitness Instructor 100.00 100.00 100.00 COM ElElOOTH OTH Self San Rafael, CA 94903 ❑ PTY ❑ SCC 8/18/24 Marilyn Nemzer ® IND Vice President 100.00 100.00 100.00 664 ❑ OTH Marin County Board of Tiburon, CA 94920 ❑ PTY Education ❑ SCC 8/18/24 Cathryn Hilliard ® IND Retired 100.00 400.00 400.00 El COM 547 Mill Valley, CA 94941 ❑ PTY ❑ SCC 8/18/24 Geza Kadar ® IND Retired 250.00 250.00 250.00 El❑ COM 4776 Santa Rosa, CA 95404 ❑ PTY ❑ Scc 8/19/24 Pamela Harlem ® IND Healthcare IT Acct Mgmt 100.00 100.00 100.00 736 ❑ OTH Self San Rafael, CA 9490 ❑ PTY SCC SUBTOTAL $ 650.00 `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period • e . NIA from 07/01/2024 I� s - • 1 through 09/21/2024 Page Of� NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 FULL NAME, STREET ADDRESS 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 8/20/24 Brian McLeran ® IND Retired 500.00 500.00 500.00 El COM ❑ OTH Novato, CA 94948 ❑ PTY ❑ SCC 9/13/24 Diana Maier ® IND Attorney 250.00 250.00 250.00 ❑ COM ❑ OTH Maier Law Group San Rafael, CA 94901 ❑ PTY ❑ SCC 9/17/24 Moulton -Peters for Supervisor 2028 Committee ❑ IND 150.00 150.00 150.00 ® COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/17/24 Mike McGuire for Insurance Commissioner 2026 ❑ IND 1,000.00 1,000.00 1,000.00 ® COM ❑ OTH Oakland, CA 94607 ❑ PTY ❑ SCC 9/19/24 Aaron Lamstein m IND Executive 1,000.00 1,000.00 1,000.00 ❑ COM ❑ OTH Alea Group LLC San Rafael, CA 94901 ❑ PTY SCC SUBTOTAL $ 2,900.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from 07/01/2024 • through 09/21/2024 Page of NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 FULL NAME, STREET ADDRESS 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9121/24 Mary De May ❑�/ IND physician 150.00 300.00 300.00 ❑ COM ❑ OTH UCSF Mill Valley, CA 94941 ❑ PTY ❑ SCC 9/21/24 Barry Moss Z IND Retired 100.00 200.00 200.00 ❑ COM ❑ OTH Tiburon, CA 94920 ❑ PTY ❑ SCC 9/21/24 Barry Moss ❑I IND Retired 100.00 200.00 200.00 ❑ COM ❑ OTH Tiburon, CA 94920 ❑ PTY ❑ SCC 9/21/24 Democratic Central Committee of Marin ❑ IND 250.00 250.00 250.00 Z COM ❑ OTH Sacramento, CA 95841 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY El SCC SUBTOTAL $ 600.00 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period -CALIFORNIA460 Supporting/Opposing Other to whole dollars. 07/01/2024 � Candidates, Measures and Committees from through 09/21/2024 Page 9 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTERAND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN. 1 - DEC. 31) (IF REQUIRED) 8/30/24 Cathryn Hilliard, Southern Marin Fire District ® Monetary Campaign contribution 100.00 100.00 100.00 Contribution ❑ Nonmonetary Contribution ❑ Independent ® Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 100.00 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.). 2. Unitemized contributions and independent expenditures made this period of under $100. 100.00 $ 0 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL.. $ 100.00 p p p ( rY 5 ) .......... FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule Amounts may be rounded to whole dollars. Statement covers period from 07/01/2024 SCHEDULE E SEE INSTRUCTIONS ON REVERSE through 09/21/2024 Page (0 of NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 CODES: €f 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 supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) North Bay Labor Council Santa Rosa, CA 95405 CODE OR DESCRIPTION OF PAYMENT PRT Advertising AMOUNT PAID 200.00 Andre Charles CNS Campaign consultant 1,000.00 Fullerton, CA 92831 Political Data Inc. POL Political data 1,200.00 Norwalk, CA 90652 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,400.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................ 2. Unitemized payments made this period of under$100......................................................................................................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)....... 3,576.26 249.73 ................................. $ 0 .................... TOTAL $ 3,825.99 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) Statement covers period ®_ , I� Amounts may be rounded Sheet) to whole dollars. (Continuation Payments Made from 07/O1/2024 -- through 09/21/2024 page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 !BODES: [f cne 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Pacific Print Resources LIT Printing of literature 286.84 Emeryville, CA 94608 Firefighters Printing LIT Printing of literature 739.42 Sacramento, CA 95833 ActBlue OFC Software 150.00 Somerville, MA 02144 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,176.26 FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov