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Form 460 - Yes on Measure E (2013-09-26)iv a Recipient Committee Campaign Statement CoverPage (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 8/23/2013 SEE INSTRUCTIONS ON REVERSE I through 9/26/2013 1- Ty p e of Recipient Committee: Al I Committees - Complete Parts 1, 2, 3, and 4. Ej Officeholder, Candidate Controlled Committee Ballot Measure Committee 0 State Candidate Election Committee (g Primarily Formed 0 Recall 0 Controlled (Also Complete Pari 5) 0 Sponsored E:] General Purpose Committee (Also Complete Part 6) 0 Sponsored F-] Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Patt 7) 3. Committee Information I.D. NUMBER 1 1359556 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee For A Safer San Rafael - Yes On Measure E STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS FPPC Toll -Free Helpline: 8661ASK-FPPC State of California ELMA IL Page 1 Of 18 Date of election if applicable: (Month, Day, Year) For Official Use Only 11/5/2013 2. Type of Statement: Preelection Statement E] Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report E] Termination Statement Supplemental Preelection [7Amendment (Explain below) Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Jeffrey Schoppert MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY Will LaBranche MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94903 OPTIONAL: FAX / E-MAIL ADDRESS FPPC Toll -Free Helpline: 8661ASK-FPPC State of California ♦ � w � # r s 17. CALIFORNIA A '• FORM 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 STREET ADDRESS (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 STREET ADDRESS (NO P.O. BOX) 6. Ballot Measure Committee NAME OF BALLOT MEASURE Measure E BALLOT NO. OR LETTER JURISDICTION SUPPORT E 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 I DISTRICT NO. IF ANY 7. Primarily Formed 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 Q SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD FISUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE . "#71I `` �. ' "``""` ""``" •`� ' "�` ` '�' Attach continuation sheets if necessary MW FPPC Form 460 June 01 FITC Toll -Free Helpline: 866/ASK-F 'PC State of California Campaign Disclosure Statemen Summary Page i Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period tram 8/23/ 2013 SEE INSTRUCTIONS ON REVERSE through 9/26/2013 Page 3 of 18 $ 10688 NAME OF FILER 0 0 8. S U BTOTAL CAS H PAYM E NTS .................................... Add Lines 6 + 7 I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E $ 5688 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 1359556 Contributions Received 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 Column A Column B Calendar Year Summary for Candidates 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 +'o $ TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 27000 $ 28250 27000 amounts in Column A to the 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule B, Line 3 from Column B of your last 15. Cash Payments.................................................. ColumnA, Line 8 above 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 27000 $ 28400 20. Contributions Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED •.......................... Add Lines 3 + 4 $ 27000 $ 28400 0 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 5688 $ 10688 7. Loans Made ............................................................. Schedule H. Line 3 0 0 8. S U BTOTAL CAS H PAYM E NTS .................................... Add Lines 6 + 7 $ 5688 $ 5688 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 5000 5000 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 +'o $ 10688 $ 10688 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 1250 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 27000 amounts in Column A to the 0 corresponding amounts 14. Miscellaneous Increases to Cash ........................... Schedule /, Line 4 from Column B of your last 15. Cash Payments.................................................. ColumnA, Line 8 above 5688 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 22562 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED.......................... Schedule B, Part 2 $ 0 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if 18. Cash Equivalents ........................................ See instructions on reverse $ 22562 any. 19. Outstanding Debts .......... ....... ..... Add Line 2 + Line 9 in Column B above $ 5000 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) 11 05 1 13 $ _J $ $ $ $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A Type or print in ink. SCHEDULE A Moneta Contributions Received Amounts may be rounded Monetary Statement covers period CALIFORNIA• to whole dollars. ' from 8/23/2013 - 4 Page of 18 SEE INSTRUCTIONS ON REVERSE 9/26/2013 through NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 8/8/13 ffr h ❑®COM IND Lawyer, 0 250 E] OTH Keegin Harrison San Rafael, CA ❑ PTY Schoppert Smith & 94903 El SCC Karner, LLP 8/21/13 Gary O. Phillips RJCOM IND Certified Public 0 1000 E] OTH Accountant, an a ae , ❑ PTY DZH Phillips LLP 94901 ❑ ScC 8/26/13 Stephen Mizroch ®IND ❑ COM Retired 500 1000 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 8/27/13 Patricia Kendall OCOM IND Physician 500 500 F] OTH Kaiser Permenente San Rafael, CA 94903 ❑ PTY ❑ SCC 8/28/13 ighters P.A.C. E]CaM 5000 10000 ® OTH San Rafael, CA 94912 ❑ PTY ❑ SCC SUBTOTAL$ 6000 Schedule A Summary 1. Amount received this period — contributions of $100 or more. (Include all Schedule A subtotals.) ....................................... ............................................... $ 2. Amount received this period — unitemized 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.) . TOTAL $ 26850 150 27000 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary contributions Received Amounts may be rounded Statement covers period to whole dollars. • • ' from 8/22/2013 • - Page 5 of 18 through 9/26/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IFCOMMITTEEHLSOI.D. NUMBER) , CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 8/30/13 Gordon Manashil k[:] COM IND Retired 200 200 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 8/30/13 C r Miller ©IND ❑ COM Retired 100 100 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/4/13 Gladys Gilliand ©IND ❑ COM Retired 200 200 ❑OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/9/13 ©IND ❑ COM Retired 250 250 ❑ OTH Novato, CA 94947 ❑ PTY ❑ SCC 9/11/13 Jeanne Leocini ©IND ❑ COM Retired 100 100 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 950 `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC—Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT) Monetary contributions Keceived Amounts may be rounded Statement covers period to whole dollars. • , from 8/22/2013 • - • Page 6 of 18 through 9/26/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE A FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED IT (IF COMMITTEE, I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 9/11/13 San Rafael Police Association ❑ IND M COM 5000 5000 ❑ OTH San Rafael, CA 94915 ❑ PTY ❑ SCC 9/11/13 Jenny Callaway MIND ❑ COM District Director 100 100 ❑OTH U.S. Congress San Rafael, CA 94901 ❑ PTY ❑ SCC 9/13/13 MIND Lawyer 100 100 1 DOTH Freitas McCarthy Machon San Rafael, CA 94901 ❑ PTY & Keating LLP ❑ SCC 9/13/13 Jack Krystal MIND ❑ COM Businessman 200 200 ❑OTH Diversified Equities San Rafael, CA 94901 ❑ PTY ❑ SCC 9/13/13 San Rafael Airport LLC El IND 5000 5000 MOTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL$ 10400 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT) Monetary contributions Received Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA• , from 8/22/2013 • - Page 7 of 18 through 9/26/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN.1-DEC. 31) (IF REQUIRED) OF BUSINESS) 9/16/13 Kate Colin ®IND ❑ COM City Council Member 500 500 DOTH City of San Rafael San Rafael, CA 94901 ❑ PTY ❑ SCC 9/18/13 ©IND Attorney 100 100 opTH Kalish Nexon LLP San Rafael, CA 94901 ❑ PTY ❑ SCC 9/18/13 ©IND ❑ COM SFFD 50 50 DOTH Fire Boat Pilot San Rafael, CA 94901 ❑ PTY ❑ SCC 9/18/13 Stephanie Plante ©IND ❑ COM President 250 250 DOTH Cal -Pox, Inc. San Rafael, CA 94901 D PTY ❑ SCC 9/23/13 Democratic Central Committee of Marin E] IND ®COM 100 100 DOTH Sacramento, CA 95841 ❑ PTY ❑ SCC SUBTOTAL$ 1000 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC —Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Gontributions Received Amounts may be rounded Statement covers period to whole dollars. • • ' from 8/22/2013 • - page 8 of 18 through 9/26/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR A O RE.ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, IT I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 9/23/13 Ph His Brinckerhoff ROOM IND CFO 150 150 DOTH HL Commercial San Rafael, CA 94901 ❑ PTY ❑ SCC 9/23/13 Sean Prendiville ©IND EICOM Systems Support Analyst y 100 100 DOTH Wells Fargo Bank an a ae , 03 ❑ PTY ❑ ScC 9/24/13 Ellen Buchen ©IND ❑ COM Retired 100 100 ❑oTH San Rafael, CA 94903 ❑ PTY ❑ SCC 9/25/13 Donal Leisey ©IND ❑ COM Retired 50 50 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/25/13 San Rafael Firefighters P.A.C. ®COM IND 5000 10000 DOTH San Rafael, CA 94912 ❑ PTY [:]SCC SUBTOTAL$ 5400 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Moneiary l.ontripuilonS KeceiVea Amounts may be rounded Statement covers period to whole dollars.• CALIF• from $/22/2013 - • Page 9 of 18 through 9/26/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE A FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED IT (IF COMMITTEE, I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 9/25/13 Stephen Mizroch ®❑IoM IND Retired 500 1000 ❑OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 9/25/13 Mar Jane Burke ©IND El COM School Superintendent p 100 100 E] OTH MCOE San Rafael, CA 94940 ❑ PTY ❑ SCC 9/26/13 Roger Smith ©❑COM IND Real Estate Sales 250 250 E] OTH Cornish & Carey San Rafael, CA 94901 ❑ PTY ❑ SCC 9/26/13 Perry Litchfield M[:] COM IND Businessman 2500 2500 E] OTH Self-employed San Rafael, CA 94901 ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 3350 `Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule B — Part Loans Received Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 8/23/2013 t Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPP( 9/26/2013 10 1 8 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL , ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT (C) AMOUNT PAID OUTSTANDING DING (e) INTEREST M ORIGINAL M CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD * PERIOD PERIOD LOAN TO DATE PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION** t Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPP( a A 0 mmzw��EVAWATWIWW %>Ut1IUUU1U D — rdf-I Ad IyjJW V1 JJIIIIL III ItIrk. Amounts may be rounded Statement covers period CALIFORNIA �4 Loan Guarantors 60 to whole dollars.8/23/2013 FORM from SEE INSTRUCTIONS ON REVERSE through 9/26/2013 Page 11 of 18 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE ZIP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMULATIVE OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) THIS PERIOD TO DATE TO DATE F] IND LENDER CALENDAR YEAR com $ ❑ OTH DATE PER ELECTION PTY (IF REQUIRED) EJ SCC CALENDAR YEAR IND LENDER com $ OTH PER ELECTION DATE (IF REQUIRED) F�PTY El SCC $ CALENDAR YEAR F-1 IND LENDER EICOM $ F-1 OTH PER ELECTION DATE (IF REQUIRED) Q PTY El SCC E] IND - -- -------- LENDER CALENDAR YEAR com $ OTH DATE PER ELECTION (IF REQUIRED) PTY 0SCC $ E on SUBTOTAL $ 0 Summary Page, Line 17 only, FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule C Type or print in ink. I- A A SCHEDULEC Nmonetary Contributions Receifl%I11%j u IM -D If Ica WIViVulluvu on ved to whole dollars. Statement covers period CALIFORNIA, from 8/23/2013 FORM SEE INSTRUCTIONS ON REVERSE through 9/26/2013 Page 12 of 18 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (IF REQUIRED) NAME OF BUSINESS) (JAN 1 - DEC 31) DINID [-]Com F710TH F-1 PTY FISCC FJIND ncom f-IOTH El PTY EISCC nIND [:]Com nOTH Q PTY EISCC nIND ncom []OTH [] PTY E1SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 01 Schedule C Summary 1. Amount received this period — nonmonetary contributions of $100 or more. (Include all Schedule C subtotals.) ............................................... .............................................................. $ 2. Amount received this period — uniternized nonmonetary contributions of less than $100 ....... ........ ............. $ U 3. Total nonmonetary contributions received this period. 0 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ IND - Individual COM - Reent Committee (other than PTY or SCC) *TH - Other PTY - Political Party i u,_L-j* ax tribi FPPC Form 460 (Junel0l) FPPC Toll -Free Helpline: 866/ASK-FPPC SUBTOTAL O 1. Contributions and independent expenditures made this period of 100 or more. (Include all Schedule D subtotals.) .............................................. 0 . Dniternized contributions and independent expenditures rade this period of under $100 ...................................................................................... 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summar Page.) TOTAL $ O FPPC Form 460 (Jure/01 FP 'C Tall -Free Helpline. 8 6/ASK-i`PPC ❑ Monetary ! ! Contribution Statement covers period F1 Nonmonetary . - ..CALIFORNIA FORS from ------------ 9/26/2013 13 18 •through PageOf OF FILER I.D. NUMBER SaferNAME Committee For A i Rafael Measure Yes On # NAME OF is AND DISTRICT,OR ! PAYMENT DESCRIPTION CUMULATIVE IIS Iu III l TO DATE i . # i CALENDAR DATE TO O. LETTER i NUMBERMEASURE JURISDICTION, OR COMMITTEE Contribution REQUIRED)OD DEC.REQUIRED) SUBTOTAL O 1. Contributions and independent expenditures made this period of 100 or more. (Include all Schedule D subtotals.) .............................................. 0 . Dniternized contributions and independent expenditures rade this period of under $100 ...................................................................................... 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summar Page.) TOTAL $ O FPPC Form 460 (Jure/01 FP 'C Tall -Free Helpline. 8 6/ASK-i`PPC ❑ Monetary Contribution F1 Nonmonetary Contribution [] Independent Q Support ❑ Oppose Expenditure Monetary Contribution [� Nonmonetary Contribution Independent ❑ Support ❑ Oppose Expenditure Monetary Contribution Nonmonetary Contribution [� Independent �] Support ❑ Oppose Expenditure SUBTOTAL O 1. Contributions and independent expenditures made this period of 100 or more. (Include all Schedule D subtotals.) .............................................. 0 . Dniternized contributions and independent expenditures rade this period of under $100 ...................................................................................... 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summar Page.) TOTAL $ O FPPC Form 460 (Jure/01 FP 'C Tall -Free Helpline. 8 6/ASK-i`PPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee For A Safer San Rafael - Yes On Measure E Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 8/23/2013 through 9/26/2013 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E Page 14 of 18 I.D. NUMBER 1359556 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 UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE 5688.00 ............................... $ (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID TBWB Strategies 5688.00 Consulting Services $5,000 CNS Reimbursables $119 5560.00 San Francisco, CA 94104 Remit Envelopes $441 Reimburse P.O. Box Rental 0an*ae E90 POS 78.00 A69 4 1 California Secretary of State Annual Committee Fee FIL 50.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 5688.00 Schedule E Summary 1. Payments made this period of $100 or more. (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.) . FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC 5688.00 ............................... $ 0 ............................... $ 0 ........... I ... ... TOTAL $ 5688.00 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule F Type or print in ink. Amounts may be roundels ' Accrued Expenses (Unpaid Bills) to whole dollars. NAME OF FILER Committee For A Safer San Rafael - Yes On Measure E Statement covers •• •• from 8/23/2013 through 9/26/20131 Page 15 of 18 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants IVITG 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 VVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER J.D. NUMBER) CODEOR(a) DESCRIPTION OF PAYMENT OUTSTANDING BALANCE BEGINNING (b) AMOUNT INCURRED THIS PERIOD (C) AMOUNT PAID THIS PERIOD (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD TBWB Strategies 400 Montgomery Street, Suite 700 CNS 0 10560 5560 5000 San Francisco, CA 94104 •I M41T.WTV11=1I momull =10T&r1r9r=1r*r:MIEWS =_1 #KM7_TW1=1W.1r_r$T I WV 10 1111^1 d HINDI 114s to I Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 10560 accrued expenses of $100 or more, plus total unitern ized accrued expenses under $100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 5560 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 5000 onthe Summary Page, Column A, Line 9.)... ................ ............................ ..................... ....... ...... .................................................... NET $ daybea-he-g-affiv-e-n-umber FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule G Type or print in ink. Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. Statement covers •• •• 8/23/2013 from -1 61MMINERIM SEE INSTRUCTIONS ON REVERSE throuqh 9/26/20 1 3 Page 16 of 18 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET- petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staffispouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candid ate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads MB 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* $ 0 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 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-1=PPC Schedule H Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 8/23/201 PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION** DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee ..... ----------------- -- --- -- must also be summarized on Schedule D Loans forgiven must SUBTICITALS 0 0 0 0 also be reported on Schedule E. (Enter (e) on Schedule 1, Line 3) Imm-11 klf:ag�r 1. Loans made this period .................................................................................................................................................. $ **If Required (Total Column (b) plus unitemized loans less than $100.) 2. Payments received on loans ................................................................................................................................... ...... $ (Total Column (c) plus uniternized payments less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................ NET 0 $ (M (Enter the net here and on the Summary Page, Column A, Line 7.) ay be a negative number) FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC 9/26/2013 17 18 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER (a) OUTSTANDING (b) AMOUNT (C) REPAYMENT OR A OUTSTA DING (e) INTEREST (Q ORIGINAL W CUMULATIVE OF RECIPIENT OCCUPATION AND EMPLOYER BALANCE LOANED THISFORGIVENESS BALANCE AT RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) BEGINNING THIS PERIOD PERIOD THIS PERIOD* CLOSE OF THIS PERIOD LOAN TO DATE r] PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION** DATE DUE DATE INCURRED PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION** DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee ..... ----------------- -- --- -- must also be summarized on Schedule D Loans forgiven must SUBTICITALS 0 0 0 0 also be reported on Schedule E. (Enter (e) on Schedule 1, Line 3) Imm-11 klf:ag�r 1. Loans made this period .................................................................................................................................................. $ **If Required (Total Column (b) plus unitemized loans less than $100.) 2. Payments received on loans ................................................................................................................................... ...... $ (Total Column (c) plus uniternized payments less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................ NET 0 $ (M (Enter the net here and on the Summary Page, Column A, Line 7.) ay be a negative number) FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC 0% bchedule I Tvna nr nrint in ink SCHEDULE Amounts may be rounded Miscellaneous Increases to Cash to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 8/23/2013 through 9/26/2013 CALIFORNIAIAfi FORM W 0 Page 18 of 18 NAME OF FILER Committee For A Safer San Rafael - Yes On Measure E I.D. NUMBER 1359556 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT of INCREASE TO CASH 1. Increases to cash of $100 or more this period . .......................................................................................................... $ 2. Uniternized increases to cash 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 SummaryPage, Line 14.) ................................................................................................ .......................... TOTAL $ SUBTOTAL $ 0 0 0 I 0 FPPC Form 460 (June/01) FPPC Toll -Free Helpline.- 866/ASK-FPPC