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HomeMy WebLinkAboutForm 460 - Revitalize San Rafael Libraries and Community Center Ad Committee's Top Funder San Rafael Public Library Foundation; preelection (Amendment)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from July 1, 2024 through September 21, 2024 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, a, and 4. ❑ Officeholder, Candidate Controlled Committee State Candidate Election Committee Recall (Also Complete Pet 5) ❑ General Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information Primarily Formed Ballot Measure Committee Controlled V Sponsored (Also Complete Pert 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/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 94912-2459 OPTIONAL: FAX / E-MAIL ADDRESS ' IEEMINI�EC_EIVEn� -- ._ .""I■ f_AI IFf)RNIA A 121f% 0 1 5 2024 0 Date of electiont app cable: Page 1 of 18 (Month, DYea For Official Use Only C TY C ERKI S OFFICE November 5, 2. Type of Statement: ❑ Preelection Statement _1 Quarterly Statement ❑ Semi-annual Statement Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) 0 Amendment (Explain below) 1) Correct calculation error in total on Schedule E. all individual amounts remain accurate. 2) Correct donation amount from Tollen on pg. 6 Treasurer(s) NAME OF TREASURER Charles 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 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my attached schedules is true and complete. I Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date 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 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of 18 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Revitalize San Rafael Libraries & Communtiy Center BALLOT NO. OR LETTER JURISDICTION San Rafael � 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 Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. SUMMARY PAGE Statement covers period from July 1, 2024 through September 21, 2024 Page 3 of 18 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1. Monetary Contributions................................................... Schedule A, Line 3 $ 16375 2. Loans Received....... ............................................ ............. Schedule B, Line 3 -5000 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 11375 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 11375 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 2990 7. Loans Made....................................................................... Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 2990 9. Accrued Expenses (Unpaid BIIIS ............. Schedule F, Line 3 0 10. Nonmonetary Adjustment........................................................ Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines6+9+10 $ 2990 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 13926 13. Cash Receipts. _. ........... ....... Column A, Line 3 above 11375 14. Miscellaneous Increases toCash...... ____...... ._ . Schedule 1, Line 4 0 15. Cash Payments _. Column A, Line s above 2990 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 22311 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 $ 22311 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $ 0 Column B CALENDAR YEAR TOTAL TO DATE $ 130428 u $ 125428 230 $ 125658 $ 110395 $ 110395 0 0 $ 110395 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ _ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure 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 Lo WHUlC oo11aQ1 Statement covers period I CALIFORNIA I ' from July 1, 2024 e FORM through September 21, 2024 Page 4 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * OCCUPATIONAND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER LD NUMBER) OF BUSINESS) PERIOD (JAN.1-DEC. 31) (IF REQUIRED) 7/8/2024 Beverly Brand El IND Retired 3000 3000 n/a ❑ OTH Crescent City, CA 95531 ❑ PTY 0 ❑ SCC 7/25/24 Sean Prendiville IND Retired 500 500 n/a ❑ COM ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 8/26/24 Friends of the San Rafael Library ❑ IND 7500 15000 n/a ❑ CoM Z OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/4/24 Alten Construction, LLC ❑ IND 2500 2500 n/a El COM ®OTH Richmond, CA 94804 ❑ PTY ❑ SCC 9/9/24 Sandra Yoffie IND Retired 150 150 n/a ❑ COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 13650 Schedule A Summary Amount received this period — itemized monetary contributions. 16375 (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. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)..... .............TOTAL $ 16375 "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 CALIFORNIA 460 from July 1, 2024 FORM through September 21, 2024 Page 5 of 18 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P 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 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) 9/12/24 Margaret Woodring IND Retired 100 100 n/a ❑ COM ❑ OTH San Anselmo, CA 94960 ❑ PTY n SCC 9/13/24 Thomas O'Brian FI: IND Retired 25 25 n/a [J COM OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/13/24 Nancy Mackle Z IND Retired 50 50 n/a ❑ COM ❑ OTH San Anselmo, CA 94960 ❑ PTY ❑ SCC 9/16/24 Paula & Mark Kamena m IND Retired 1000 1000 n/a El COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/16/24 Frances Scher IND Retired 500 500 n/a ❑ COM ❑ OTH San Rafael, CA 94903 ❑ PTY n SCC SUBTOTAL $ 1675 "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 CALIFORNIA from July 1, 2024 FORM through September 21, 2024 Page 6 of 18 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 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) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/16/24 Ellen & Robert Tollen IND Retired 200 200 n/a El COM ❑ OTH San Rafael, CA 94901-1354 ❑ PTY ❑ SCC 9/16/24 Wayne Lechner ® IND Gardner 100 100 n/a ❑ COM ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 9/16/24 Seagate Properties, Inc. ❑ IND 500 500 n/a ❑ COM W1 OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/16/24 Ann Batman IND Retired 200 200 n/a ❑ COM ❑ OTH Larkspur, CA 94904 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY n SCC `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL $ 1050 1, FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE B-PART 1 Schedule B — Part 1 to whole dollars. Statement covers period . Loans Received from iuly 1, 2024 • ' ' • through September 21, 2024 Page 7 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREETADDRESS AND ZIP CODE IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING AMOUNT c AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OF LENDER BALANCE RECEIVED THIS OR FORGIVEN BALANCEAT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THISPERIOD- CLOPERIOD EOFTHIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD ® PAID CALENDAR YEAR Charles Litchfield Real Estate Broker $ 5000 $ 0 0 $ 5000 5000 Litchfield Brokers $ ❑ FORGIVEN RATE PER ELECTION" $ 5000 0 $ 3/26/24 n/a t ® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ S DATE DUE DATE INCURRED $ PAID CALENDAR 7ffA-W- $ % $ $ ❑ FORGIVEN RATE PER ELECTION" ❑ IND ❑ COM ❑ OTH El El tEl $ $ $ DATE DUE $ $ DATE INCURRED ❑ PAID CALENDAR YEAR $ S S $ ❑ FORGIVEN PER ELECTION- RATE $ S $ $ $ DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE SUBTOTALS $ 0 $ 5000 $ 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 $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.)................................................. Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. "" If required. ................$ $ 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 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 Scneauie b — Fart 1 Amounts may oe rounaea Statement covers period to whole dollars. CALIFORNIA Loan Guarantors July 1, 2024FORM• from through September 21, 2024 Page 8 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE BALANCE CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) THIS PERIOD TO DATE TO DATE LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑SCC s LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC $ CALENDARYEAR LENDER ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH ❑ PTY DATE PER ELECTION (IF REQUIRED) ❑ SCC $ SUBTOTAL $ Summary Page, Line 17 cry FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHFDL)LF C ." Nonmonetaily Contributions Received ...... Statement covers period CALIFORNIA from July 1, 2024 FORM 460 through September 21, 2024 Page 9 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME, STREETADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER LD NUMBER) CODE* IFEMPLOYED (SE, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF REQUIRED) NAME OF BUSINESS) (JAN 1 -DEC 31) ❑ IND ❑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 $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)................................................................. . 2. Amount received this period — unitemized nonmonetary contributions of less than $100 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) .1...........I..............$ ..TOTAL $ _ "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 Schedule D Summary of Expenditures Amounts may be rounded Supporting/Opposing Other to whole dollars. Candidates, Measures and Committees Statement covers period from luly 1, 2024 SCHEDULE D through September 21, 2024 Page 10 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees 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 CALENDAR YEAR TO DATE OR COMMITTEE (IF REQUIRED) PERIOD (JAN 1 -DEC. 31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure_ ❑ Monetary _ Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose I Expenditure SUBTOTAL $ 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.................................................................................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ 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 ExpendituresCALIFORNIA Supporting/Opposing Other Statement covers period from July 1, 2024 , FORM 60 Candidates, Measures and Committees through September 21, 2024 Page 11 of 18 NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1- DEC. 31) PER ELECTION TO DATE (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period from July 1, 2024 through September 21, 2024 I page 12 of 18 Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment 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) Neilsen Merksamer et al PRO 2278 o_- n_c__1 !'A nAn I� eFundraising Connections Credit Card Discounts on Donations Made by Credit Cards 712 c---------- nA nrOlL * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 2990 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2990 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 2990 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) (Continuation Sheet) Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA . ' Payments Made from July 1, 2024 FORM through September 21, 2024 Page 13 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 167556 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. SUBTOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from July 1, 2024 through September 21, 2024 • ' • - 14 18 Page of NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P 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 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 CREDITOR (IF COMMITTEE, ALSO ENTER I D. 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 ' Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ $ summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.).................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Paae. 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 F (Continuation Sheet) Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. Statement covers period from July 1, 2024 SCHEDULE F (CONT.) through September 21, 2024 15 18 Page of NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P 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 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 (b) AMOUNT INCURRED THIS PERIOD M AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD SUBTOTALS $ FPPC Form 460 (Jan/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 CALIFORNIA , ' Contractor (on Behalf of This Committee) to whole dollars. from July 1, 2024 • FORM through September 21, 2024 16 18 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 NAME OFAGENT OR INDEPENDENT CONTRACTOR 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. Attach additional information on appropriately labeled continuation sheets. TOTAL* $ * 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. Loans Made to Others* from July 1, 2024 • - through September 21, 20a Page 17 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a OUTSTANDING AMOUNT c REPAYMENT OR OUTSTANDING to ORIGINAL y CUMULATIVE OF RECIPIENT (IF COMMITTEE,ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS LOANED THIS FORGIVENESS BALANCEAT CLOSE OF THIS INTEREST RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) PERIOD THIS PERIOD* LOAN TO DATE ❑ PAID CALENDAR YEAR $ $ 46 $ $ ❑ FORGIVEN PER ELECTION" RATE DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ h $ $ RATE ❑ FORGIVEN PER ELECTIONf DATE INCURRED DATE DUE *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 $ $ $ $ (Enter (e) on Schedule I, Line 3) Schedule H Summary Loansmade this period....................................................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) Payments received on loans............................................................................................................................................$ (Total Column (c) plus unitemized payments of less than $100.) Net change this period. (Subtract Line 2 from Line 1.)............................................................................................ NET $ (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.fppc.ca.gov Schedule I Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. Statement covers period frnm July 1, 2024 through Setember 21, 2024 NAME OF FILER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT RECEIVED I (IF COMMITTEE, ALSO ENTER I D NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period . ........................................................................................................................... $ o 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).)....................... ....... ......... $ o 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 0 SummaryPage, Line 14.)............................................................................................................................. TOTAL $ — SCHEDULEI Page 18 of 18 I.D. NUMBER 1467556 AMOUNT OF INCREASE TO CASH SUBTOTAL$ 0 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov