No preview available
HomeMy WebLinkAboutForm 460 - Revitalize San Rafael Libraries and Community Center Ad Committee's Top Funder San Rafael Public Library Foundation; 2nd preelectionCOVER PAGE Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE from Statement covers period September 22, 2024 through October 19, 2024 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑� Primarily Formed Ballot Measure State Candidate Election Committee Committee Recall Controlled (Also Complete Part 5) v/ Sponsored (Also Complete Part 6) ❑ General Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAVE IF NO COM ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1467556 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 AREA CODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) N0. AND STREET OR P.O. BOX CI'v STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94912-2459 OPTIONAL: FAX / E-MAIL ADDRESS Date Stamp GIS0WCE P 1 of 17 Date of election if appliihA (Month, Day, Year) ocT z 4 2024 For Official Use Only November 5, 2024 r 2. Type of Statem Z Preelection Statement E] 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 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 AREACODE/PHONE San Rafael CA ci 94901 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 Date Executed on By Dalesignature at comrolling Officeriolder. Candidate. State Veasure Proponeril or Responsible Officer of Sponsor Executed on Date By Signature of Contribilling OfficehoWer, Cartd:date, State Measure Proponent Executed on By Signature of Controlling Otticeho:der, 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) RESIDENTIA:/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 I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NC COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of 17 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees To BALLOT NO. OR LETTER JURISDICTION ❑� SUPPORT p City of 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 Listnames of offlceholderf 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 2GC IAICTRIIRTIr1NC r)N RF\/FRiF Amounts may be rounded to whole dollars. statement covers period from September 22, 2024 through October 19, 2024 NAME OF FILER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation Column A Column B Contributions Received TOTALTHIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE 12700 $ 143128 1. Monetary Contributions................................................... Schedule A, Line 3 $ 0 -5000 2. Loans Received .............................................. .................. Schedule B, Line 3 12700 138128 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 +2 $ $ 0 0 4. Nonmonetary Contributions.... __ .. Schedule C, Line 3 12700 $ 138128 5. TOTAL CONTRIBUTIONS RECEIVED..............................Add Lines 3+4 $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 9170 $ 119565 0 0 . ...................................................... 7. Loans Made.. .......... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..................................... Add Lines 6+7 $ 9170 $ 119565 9. Accrued Expenses (Unpaid Bills) .... Schedule F, Line 0 0 0 0 ... 10. Nonmonetary Adjustment ........................................ . .......... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE...............................Add Lines 8+9+10 $ 9170 $ 119565 Current Cash Statement 12. Beginning Cash Balance ........................... Previous Summary Page, Line 16 $ 22311 13. Cash Receipts ........................................................... Column A, Line 3 above 12700 14. Miscellaneous Increases to Cash Schedule I, Line 4 0 15. Cash Payments......................................................... Column A, Line 6 above 9170 16. ENDING CASH BALANCE ...Add Lines 12 + 13 + 14, then subtract Line 15 $ 25841 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents .............................................. See instructions on reverse $ 25841 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $ 0 SUMMARY PAGE Page 3 of 17 I.D. NUMBER 1467556 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 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/dd/yy) $ To calculate Column B, add amounts in Column A to the corresponding *Amounts in this section may be different from amounts amounts from Column B reported in 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). 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 ..L_1_ J_11.. �.. Monetary Contributions Received - - - -- - - statement covers period CALIFORNIA 1 from September 22, 2024 -. through October 19, 2024 Page 4 of 17 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 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 LD, NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN.1-DEC. 31) (IF REQUIRED) Z IND 9/24/2024 Kate Colin ❑COM Mayor 400 1400 N/A ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC Z IND 9/24/2024 Kay & Mark Noguchi ❑ COM Retired 500 500 N/A ❑ OTH San Rafael, CA 94903-2428 ❑ PTY ❑ SCC Z IND 9/24/2024 Ann Rivo ❑ COM Retired 100 100 N/A ❑ OTH San Rafael, CA 94903-5105 ❑ PTY ❑ SCC OIND 10/05/2024 Barbara Squires El Personal Assistant 50 143 N/A 86 Greenbrea, CA 4904 ❑ PTY ❑ SCC Z IND 10/11/2024 Gladys Liand ❑ COM Insurance Agent 150 150 N/A 600 San Rafael, CA 94903-5517 ❑ PTY ❑ SCC SUBTOTAL $ 1200 Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)..................................................................... 2. Amount received this period — unitemized monetary contributions of less than $100 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.). 12700 ...$ S_ '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 TOTAL $ 12700 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 , ' from September 22, 2024 • through October 19, 2024 Page 5 of 17 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑� IND 10/11/2024 Pamela & Willard Dixon ❑ COM Artist 500 1000 N/A ❑ OTH San Rafael, CA 4901-1625 ❑ PTY SCC ❑� IND IND 10/ 11/2024 Lois & Frank Noonan ❑ Retired 10000 10000 N/A ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ❑ IND IND 10/16/2024 Joe O'Hehir ❑ Retired 1000 2000 OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 11500 *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 1 1 R eived Amounts may be rounded to whole dollars. SCHEDULE B - PART 1 Statement covers period • . ' Se-tember 22 2024 • oans eC I from through October 19, 2024 page 6 of 17 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 AMOUNT PAID OUTSTANDING le INTEREST ) ORIGINAL (01 CUMULATIVE OF LENDER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS COMMITTEE,ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD* CLOSE OF THIS PERIOD LOAN TO DATE (IF NAME OF BUSINESS) PERIOD PERIOD ❑ PAID CALENDARV A $ S ❑ FORGIVEN PER ELECTIOIJ* RATE $ $ $ S S DATE INCURRED 1 ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE PAID AL N A A $ $ k S g RATE ❑ FORGIVEN PER ELECTION" S $ g S $ DATE INCURRED 1 ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE ❑ PAID CALENDAR YEAR 5 S % $ $ PER ELECTION" ❑ FORGIVEN RATE S $ $ S $ t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ 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. 0 00 0.00 ...... I ..... NET $ 0.00 (May be a negative number) (Enter (e) on E Line 3) tContributor 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 B - PART 2 Schedule B — Part 2 Amounts may be rounded Statement covers period - to whole dollars. ' Loan Guarantors September 22, 2024 - , from October 19 2024 7 17 SEE INSTRUCTIONS ON REVERSE through , 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 FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR [FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE BALANCE CONTRIBUTOR * CODE (IF SELF-EMPLOYED, ENTER LOAN GUARANTEED THIS PERIOD TO DATE OUTSTANDING TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION _ PTY (IF REQUIRED) ❑ SCC y LENDER CALENDAR YEAR ❑ IND ❑ COM s ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC s CALENDAR YEAR LENDER ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC s SUBTOTAL $ Summary Page, Line 17 only FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C w wnu�e uUuais. Statement covers eriod Nonmonetary Contributions Received pCALIFORNIA , September 22, 2024 from - 0 through October 19, 2024 Page 8 of 17 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME,STREETADDRESSAND CONTRIBUTOR [FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * CODE (IF SELF-EMPLOYED, ENTER NAME BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) OF ❑ 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 $ L Schedule C Summary 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.) 0.00 0.00 0.00 . TOTAL $ 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees Amounts may be rounded to whole dollars. Statement covers period from September 22, 2024 SCHEDULE D through October 19, 2024 I page 9 of 17 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 AMOUNTTHIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT CALENDAR YEAR TO DATE OR COMMITTEE I (IF REQUIRED) PERIOD (JAN 1 -DEC 31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution I ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution i ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ..................................... 0.00 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................... $ 0.00 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) __ _ TOTAL.. $ 0.00 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. Statement covers period Summary of Expenditures Supporting/Opposing Other from September 22, 2024 . - Candidates, Measures and Committees through October 19, 2024 Page 10 of 17 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 I 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 Schedule E Amounts may be rounded Statement covers period to whole dollars. Payments Made from September 22, 2024 through October 19, 2024 1 Page 11 of 17 SEE INSTRUCTIONS ON REVERSE I NAME OF FILER I.D. NUMB! 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 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) CivX t11r`rnkC* � �--°1 q03 CODE OR DESCRIPTION OF PAYMENT CNS/ CMP a Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary AMOUNT PAID Campaign Consultant; Lawn Sign Design & Printing I 9170 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.) SUBTOTAL $ 9170 9170 ........................................ $ ........................................ $ ........................................ $ ........................... TOTAL $ 9170 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made from tement covers period September 22, 2024 SCHEDULE E (CONT.) SEE INSTRUCTIONS ON REVERSE I through October 19.2024 Page 12 of 17 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 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) x 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 Schedule F Amounts may be rounded to whole dollars. Accrued Expenses (Unpaid Bills) INSTRUCTIONS ON R Statement covers period from September 22, 2024 through October 19, 2024 NAME OF FILER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation SCHEDULEF Page 13 of 17 I.D. NUMBER 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 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 CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNTINCURRED 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 summarized on Schedule D. Schedule F Summary SUBTOTALS $ 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.) ........................ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, ILIs total unitemized payments on accrued expenses under $100.).. INCURRED TOTALS $ PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. Statement covers period from September 22, 2024 SCHEDULE F (CONT.) NAME OF FILER through October 19, 2024 14 17 Page of 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 (c) 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 Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Amounts may be rounded to whole dollars. SCHEDULE G Statement covers period from September 22, 2024 through October 19, 2024 Pa 15 of 17 Page 9 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 AGENT 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 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) 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 independent contractor as reported on Schedule E. ppc. Form 460 (Jan5-3772) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period CALIFORNIA Loans Made to Others* to whole dollars. from September 22, 2024 FORM 46 through October 19, 2024 Page 16 of 17 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 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (bl AMOUNT (Cl REPAYMENT OR ( OUTSTANDING e ORIGINAL g CUMULATIVE OF RECIPIENT (IF COMMITTEE, ALSO ENTER LID, NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE ING THIS BEGPE LOANEDTHIS FORGIVENESS BALANCE AT CLOPF OF THIS INTEREST RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) RIOD PERIOD THIS PERIOD' LOAN TO DATE ❑ PAID CALENDAR YEAR S S % S S PER ELECTION" ❑ FORGIVEN RATE S S S S S DATE INCURRED DATE DUE ❑ PAID CALENDAR YEAR S s % $ ❑ FORGIVEN RATE PER ELECTIONPk S S S S S 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 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 $100.) 3. Net change this period. (Subtract Line 2 from Line 1.)........................................................ (Enter the net here and on the Summary Page, Column A, Line 7.) ...............................$ ............. NET $ `*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 September 22, 2024 SCHEDULEI through October 19, 2024 Page 17 of 17 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Revitalize San Rafael Libraries & Community Center - Yes on P Ad Committees Top Funder San Rafael Public Library Foundation 1467556 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF DESCRIPTION OF RECEIPT RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule 1 Summary 1. Itemized increases to cash this period....................................................................... ..................................................... $ - 2. Unitemized increases to cash of under $100 this period . .............................. .... ......... ........ .._............ ...... ...................... $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)....................... .... ....... .....$ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.).............................................................................................................. TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov