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Home My WebLink AboutForm 460 - Damon Connolly for City Council 2015 (2013-06-30)09 0 & ReCiplient Committee R PAGE � Type or print in ink. Campaign Statement � �� a>•npt d ' ` Cover Page , ! (Government Code Sections 84200-84216.5) Page of Statement covers period Date of election if applicable: 01/01/2013 (Month, Day, Year) For Official Use Only from 06/30/2013 v m �<a_ SEE INSTRUCTIONS ON REVERSE through 1. Type of Recipient Committee: All Committees -- Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee [❑ Primarily Formed Ballot Measure Q Preelection Statement Q Quarterly Statement 0 State Candidate Election Committee Committee 6Z Semi-annual Statement F-1 Special Codd -Year Report 0 Recall 0 ControlledTermination Statement E] F-1 Supplemental Preelection (Also Complete Part 5) Sponsored (Also file a Form 410 Termination) Statement - Attach Form 495 General Purpose Committee (Also Complete Part 6) EJ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information E.D. NUMBER Treasurer(s) 1299779 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Damon Connolly for City Council 2015 Gary Anspach MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY San Rafael CA 94903 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX J E-MAIL ADDRESS 4. verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowle e the informa . contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 1;71 Executed on By Date Executed /3 :3 By Sicgn re o easure sis nt Tr surer on Date Signature of Controlling Officeholder, Candidate, State Measure Pr nent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, Stme Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (€366/275-3772) State of California I t 0 Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee 0 Type or print in ink. NAME OF OFFICEHOLDER OR CANDIDATE Damon M. Connolly OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) San Rafael City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael 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 CA 94903 NAME OF TREASURER CONTROLLED COMMITTEE? F] YES n 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? n YES NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 0 COVER PAGE -PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION F-1 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 F] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E]SUPPORT F�OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. * 'Statement covers period from 01/01/2013 to SUMMARY PAGE FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 06/30/2013 03 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Damon M. Connolly 1299779 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 14525 .00 $ 14525.00 2. Loans Received ...................................................... Schedule B, Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 14525.00 $ 14525.00 20. Contributions 4. Nonmonetary Contributions .................................... Schedule C, Line 3 1072.00 1072.00 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 15597.00 $ 15597.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line 4 $ 5863.00 $ 5863.00 Candidates 7. Loans Made ............................................................. Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 5863.00 $ 5863.00 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0.00 0.00 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 1072.00 1072.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 6935.00 $ 6935.00 $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous Summary Page, Line 16 $ 25080.00 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 14525.00 amounts in Column A to the 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 0.00 corresponding amounts from Column B of your last *Amounts in this section may be different from amounts reported in Column B. 15, Cash Payments .................................................. Column A, Line 8 above 5863.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ . 3374200 figures that should be subtracted from previous ifthis is a termination statement, Line 16 must be zero. peNod amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED..................... ...... Schedule B, Part 2 $ 0.00 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 $ 0.00 any). 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 0.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 0 Schedule A Monetary Contributions Received is Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 0 SCHEDULE A SEE INSTRUCTIONS ON REVERSE through 06/30/2013 Page of NAME OF FILER I.D. NUMBER Damon M. Connolly 1299779 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) No. California Carpenters Regional Council ❑ IND 4/26/13 Small Contributor Commitee ID #972104 VCOM MOTH 1000.00 1000.00 265 Hegenberger Road, Suite 200 ❑ PTY Oakland, CA 94621 F-1 SCC Marin Building Trades Council, PAC #900667 [:] IND 4/26/13 4174 Redwood HIghway VCOM R OTH 250.00 250.00 San Rafael, CA 94903 F-1 PTY LSCC Operating Engineers Local Union No. 3 MIND 5/8/13 District 10 PAC, ID # 891395 WCOM F-1 OTH 200.00 200.00 1620 South Loop Road Q PTY Alameda, CA 94502 F-1 SCC SF Laborers Local 261, PAC -ID #981076 ❑ IND 5/10/13 3271 - 18th Street PICOM r-1 OTH 500.00 500.00 San Francisco, CA 94110 F] PTY F-1 SCC Jack Krystal PJIND ❑Com Businessman/ 5/24/13 r_� OTH Diversified Realt y 150.00 150.00 San Rafael, CA 94901 Fj PTY Services EISCC SUBTOTAI ..... � 2100.00 5cneaulleASummary 1. Amount received this period — itemized monetary contributions. 12300.00 (Include all Schedule A subtotals.) ........................................................................................................ $ 2. Amount received this period — uniternized monetary contributions of less than $100 ............................ $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 2225.00 is= *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other •(e.g., business entity) PTY — Political Party SGG —661-r1kit"Iff FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 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. CALIFORNIA 01/01/2013 FORM 46 from01 through 06/30/2013 Page 45 . of NAME OF = ER I.D. NUMBER 1299779 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Roger Roberts IND Retired 5/24/13 F-1 COM ROTH 100.00 100.00 San Rafael, CA 94901 F] PTY R SCC Robert Dobrin VIIND Owner/ 5/24/13 RCOM Electra Chime 150.00 150.00 San Rafael, CA 94903 ROTH R PTY 0SCC Dennis Fisco PJIND Investor/ 5/24/13 RCOM Seagate Properties 250.00 250.00 San Rafael, CA 94901 R OTH R PTY RSCC Stephen Mizroch VIND Retired/ 5/30/13 EICOM Physician 150.00 150.00 San Rafael, CA 94901 ROTH R PTY R SCC William Ca ' Carney ®IND Landscape Architect/ 5/30/13 RCOM Self -Employed 150.00 150.00 San Rafael, CA 94901 ROTH R PTY TY SUBTOTAL$ 800.00 *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period A A A =. 0. from 01/01/2013 � � icA& a im s through 06/30/2013 Page 6V of ... . .. ..... . .... .. NAME OF FILER f X I.D. NUMBER 1299779 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Tamra Peters VIND Director/ 5/30/13 F-1 COM [:]OTH Resilient Neighborhoods 150.00 150.00 San Rafael, CA 94901 F1 PTY F71 SCC Gary Anspach TND Enrolled Agent/ 5/30/13 1771 COM Anspach Financial Group 100.00 100.00 San Rafael, CA 94901 F-1 OTH ❑ PTY ❑ SCC Stuart Lum IND Banker/ 5/30/13 RCOM Self -Employed 150.00 150.00 San Rafael, CA 94901 FJOTH R PTY RSCC Robert Towler JZIND Retired 5/30/13 RCOM 300.00 500.00 San Rafael, CA 94903 ROTH R PTY R SCC Jeff Brusati IND Owner/ 5/31/13 RCOM T&B sports 150.00 150.00 San Rafael, CA 94903 ROTH R PTY El SCC SUBTOTAL $ 850.00 *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Receiveli 40 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 00. SCHEDULE A (CONT.) *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or OTH — Other (eg., business entity) Political Party SCC — Small Contributor Committee SUBTOTAL $ 900.0411 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) through 06/30/2013 Page of NAME OF FILER I.D. NUMBER 1299779 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 OF BUSINESS) PERIOD (JAN. I - DEC. 31) (IF REQUIRED) Perry D. Litchfield WIND Businessman/Attorney 5/31/13' CJ COM F�OTH Self -Employed 500.00 500.00 San Rafael, CA 94901 F-1 PTY M SCC Peter Tiernan ®IND Union Agent/ 5/31/13 MCOM Public Employees Union, 100.00 100.00 Novato, CA 94947 DOTH Local One ❑ PTY M SCC Rod Blouin PJIND Architect/ 5/31/13 F-1 COM Basis Architecture 100.00 100.00 San Rafael, CA 94903 ❑OTH F-1 PTY ❑ SCC Brian Young ®IND Telecom Director/ 6/2/13 RCOM Resource Telecom LLC 100.00 100.00 San Rafael, CA 94903 ROTH R PTY RSCC Lori G ' race ®IND Philanthropist/ 6/3/13 RCOM Self -Employed 100.00 100-00 Tiburon, CA 94920 ROTH R PTY []SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or OTH — Other (eg., business entity) Political Party SCC — Small Contributor Committee SUBTOTAL $ 900.0411 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 1 0 Schedule A (Continuation Sheet) Monetary Contributions Received 41 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 0 SCHEDULE A (CONT) Contributor Codes Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL $ 1450.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) through 06/30/2013 Page Of NAME OF FILER VV) I.D. NUMBER 1299779 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Robert C. Placak JOIND Owner/ 6/5/13 FJCOM nOTH Robert C. Placak & 100.00 100.00 San Rafael, CA 94901 n PTY Associates nSCC The Tompkison Group E]IND 6/5/13 ncom 100.00 100.00 San Jose, CA 95124 WJOTH n PTY EISCC Resource Conservation PAC, ID #1347886 nIND 6/5/13 ® COM 500.00 500.00 San Rafael, CA 94901 nOTH ® PTY n ScC Amalgamated Transit Union, Special Holding n IND 6/5/13 Account ID #841627 jzCOM 250.00 250.00 5025 Wisconsin Avenue NW F] OTH Washington, DC 20016 n PTY F1 ScC Marin Sanitary Service F-JIND 6/6/13 1050 Andersen Drive nCOM 500.00 500.00 San Rafael, CA 94901 JOOTH n PTY ❑ ScC Contributor Codes Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL $ 1450.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) j *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity)l PTY Political Paq SCC - Small Contributor Committee - FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers peri od tow dollars. CALIFORNIA from 01/01/2013 FORM 4601 through 06/30/2013 Page of .......... .. t NAME OF ALER A I.D. NUMBER 1299779 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) N. Edward Boyce ® IND Retired/ 6/11/13 � COM F-1 OTH Physician 250.00 250.00 San Rafael, CA 94901 ❑ PTY M SCC Pamela Reaves V IND Psychologist/ 6/12/13 ❑COM Self -Employed 100.00 100.00 San Rafael, CA 94903 F-1 OTH r-1 PTY F] SCC Lawrence A. Strick P1 IND Attorney/ 6/13/13 M COM Self -Employed 100.00 100.00 San Rafael, CA 94901 F-1 OTH ❑ PTY ❑SCC Brendan Connolly ®IND Teacher/ 6/14/13 Ethern Efendi Cad. Ulke Sok. No 5/15 F-1 COM Self -Employed 400.00 400.00 Istanbul, Turkey F� OTH F-1 PTY ❑SCC Frank Gobar VIND Energy Consultant/ 6/17/13 MCOM Danlin Corp. 250.00 250.00 San Rafael, CA 94903 BOTH ❑ PTY [:]SCC SUBTOTAL $ 1100.00 j *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity)l PTY Political Paq SCC - Small Contributor Committee - FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) 0 5 Schedule A (Continuation Sheet) Monetary Contributions Received 9 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013- 0 SCHEDULE A (CONT.) *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) through 06/30/2013 Page Of NAME OF FILER to"*— I.D. NUMBER 1299779 DATE FULL Spofford ®IND Retired 6/10/13 ICOM 250.00 250.00 San Rafael, CA 94901 nOTH F1 PTY n SCC Charles M. Louderback PJIND Attorney/ 6/11/13 ncom Louderback Law Group 100.00 100.00 San Rafael, CA 94901 nOTH n PTY nSCC Catherine L. Rice RJIND Supervisor/ 6/11/13 F-1 COM Marin County 100.00 100.00 San Anselmo, CA 94960 nOTH Q PTY SCC SUBTOTAL $ 1150.00 mfr *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet). Monetary Contributions Received NAME OF FILER V0 VO - G8-� Vl 0 1 � t do Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 through 06/30/2013 0 SCHEDULE A (CONT.) I.D. NUMBER 1299779 DATE Ij FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF 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) I OF BUSINESS) Michele C. Hodge WIND Educator/ 6/18/13 ICOM r-1 OTH Dixie School District 100.00 100.00 Kentfield, CA 94904 ❑ PTY EISCC Robert Reyff V IND Attorney/ 6/19/13 RCOM CA Attorney General's 150.00 150.00 San Rafael, CA 94903 � OTH Office F1 PTY F] SCC Philip Benson ® IND Financial Planner/ 6/19/13 ❑Com Philip Benson Financial 250.00 250.00 Fairfax, CA 94930 ROTH Services ❑ PTY F1 SCC Sharon D. Green WIND Attorney/ 6/20/13 EICOM Delfino Green & Green 100.00 100.00 San Rafael, CA 94903 F-1 OTH ❑ PTY FJSCC Jonathan Leidy JZIND Principal/ 6/20/13 FICOM Portico Wealth Advisors 100.00 100.00 San Rafael, CA 94901 ❑ OTH ❑ PTY [:]SCC rF *Contributor Codes IND—Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL $ 700.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) RA a. Y ALw&.au a ^ i YL_!L_ ..A! — — — r% — — — !_ __ —1 M Type or print in ink. SCHEDULE A (CONT.) 1V1V11t;LC11y %.#V11L1_11JULKJF15 MUGUIVeU Amounis may De rounaea Statement covers period to whole dollars. A from 01/01/2013 Page of through 06/30/2013 NAME OF FILER I.D. NUMBER 1299779 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) Stephen Johnson RIND Consultant/ 6/21/13 F-1 COM F-JOTH Conservation Strategy 150.00 150.00 San Rafael, CA 94901 F-1 PTY Group ❑ SCC Frank Nelson ®IND Retired 6/21/13 F1COM 100.00 100.00 San Rafael, CA 94903 Q OTH F-1 PTY F�SCC Jeff Bialik ®IND Executive Director/ 6/21/13 ❑COM Catholic Charities CYO 150.00 150.00 San Rafael, CA 94903 ROTH F-1 PTY ❑Scc Jason Wong RIND Senior Inspector/ 6/22/13 ❑ COM US Marshals Service 150.00 150.00 San Rafael, CA 94903 ❑ OTH F-1 PTY SCC Thomas McInerney ®IND Attorney/ 6/22/13 MCOM Ogletree Deakins 150.00 .150.00 San Anselmo, CA 94960 F-1 OTH � PTY EISCC *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 $ 700.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. Im SCHEDULE A (CONT) Moneta Uytoun nouxions Received Amounts may oe rounaea Statement covers period to whole dollars. from 01/01/2013 m :0 Page J of through 06/30/2013 NAME OF FILER I.D. NUMBER L 1299779 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 OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Peggy Butler VIND Tech Consultant/ 6/22/13 DCOIVI ❑ OTH Self -Employed 100.00 100.00 San Rafael, CA 94901 F� PTY FSCC Christopher D. Sullivan ®IND Attorney/ 6/22/13 FCOM Greenfield Sullivan Draa 100.00 100.00 San Rafael, CA 94901 D OTH & Harrington LLP F� PTY M SCC Carolyn Lenert ®IND Realtor/ 6/22/13 ❑ COM Alain Pinel 100.00 100.00 San Rafael, CA 94903 ❑ OTH ❑ PTY ❑ SCC Sean R. Broderick JZIND Attorney/ 6/22/13 MCOM Louderback Law Group 100.00 100.00 San Francisco, CA 94114 ❑ OTH F❑ PTY F ] SCC Lynn A. Bornstein VIND Retired 6/22/13 MCOM 100.00 100.00 Greenbrae, CA 94904 ❑ OTH Q PTY ❑SCC IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) Political Party SCC — Small Contributor Committee SUBTOTAL $ 500.00 ,MENOMONEE FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) 0 0 Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) 1V1V11ULdF_y %.*UFIIUIDUIIOnSmeceivea Amounts may be rounaea Statement covers period to whole dollars. CALIFORNIA 4601 from 01/01/2013 FORM 0) through 06/30/2013 Page of NAME OF FILER I.D. NUMBER 1299779 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. I - DEC. 31) (IF REQUIRED) OF BUSINESS) Jonathan Frieman VIND Philanthropist/ 6/22/13 RCOM ROTH Self -Employed 250.00 250.00 San Rafael, CA 94901 R PTY RSCC Patrick M. Seidler ®IND Executive/ 6/22/13 RCOM WTB, Inc. 100.00 100.00 Mill Valley, CA 94941 ROTH R PTY [:] SCC Cohen for DCCM 2012, ID #1346679 RIND 6/22/13 PICOM 100.00 100.00 San Rafael, CA 94901 ROTH R PTY F] SCC Karen Nygren ®IND Retired 6/22/13 RCOM 100.00 100.00 Tiburon, CA 94920 ROTH R PTY R SCC Michael Allen for Assembly 2012, ID #1335032 FJIND 6/22/13 VCOM 1000.00 1000.00 Santa Rosa, CA 95402 ROTH R PTY [:] SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (eg., business entity) Political Party SCC — Small Contributor Committee SUBTOTAL $ 1550.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) 0 Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. from Statement covers period 01/01/2013 0 SCHEDULE A (CONT) Fr- -- *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) through 06/30/2013 Page of3i NAME OF FILER I.D. NUMBER 1299779 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) Russ Hamel VIND Director of Development/ 6/24/13 . F-1 COM F-1 OTH Community Action Marin 250.00 250.00 San Rafael, CA 94901 R PTY R SCC Miller Hauser Law Group LLP R IND 6/29/13 RCOM 150.00 150.00 San Francisco, CA 94111 VIOTH R PTY RSCC Karen Ellingboe OIND CFO/ 6/29/13 RCOM West, Inc. 100.00 100.00 Larkspur, CA 94939 ROTH F] PTY R SCC R IND RCOM ROTH R PTY R SCC F-1 IND RCOM ROTH R PTY SCC SUBTOTAL $ 500.00 Fr- -- *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule C Type or print in ink. oustsr"n be rasa A ■ SCHEDULE Nonmonetary Contributions Received to whole dollars. Statement covers period - from 01/01/2013 CALIFORNIA FORM 460 I � Al through 06/30/2013 SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER I.D. NUMBER d' VVA 129977 rl DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR CODE Ap, !FAN 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) (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) Terri De Langis ®IND Financial Counselor/ Entertainment for 6/22/13 FJCOM Self -Employed Event 350.00 350.00 San Rafael, CA 94903 MOTH F-1 PTY EISCC United Markets F-JIND Food for Event 6/22/13 RCOM 437.00 437.00 San Rafael, CA 94901 EOTH [--i PTY EISCC Andys Local Market �IND Food for Event 6/22/13 �COIVI 100.00 100.00 San Rafael, CA 94901 PIOTH R PTY FISCC Marin Professional Firefighters PAC RIND BBQ/Charcoal 6/22/13 ID #930791 PICOM 185.00 185.00 P.O. Box 15 ❑OTH Fairfax, CA 94978 F-1 PTY EISCC zw 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 — uniternized nonmonetary contributions of less than $100 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ *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 Statement covers period from 01/01/2013 through 0 SCHEDULED 06/30/2013 of I.D.NUMBER 1299779 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) NAME 111 n1 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD OR COMMITTEE Sonoma County Democratic Central Monetary 1/19/13 Committee Contribution 150.00 Nonmonetary Contribution Independent 21 Support ❑ Oppose Expenditure Mike McGuire for Sonoma County Supervisor Monetary 2/6/13 Contribution E] Nonmonetary 100.00 Contribution Independent 21 Support ❑ Oppose Expenditure W11-1011 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E Payments Me Md (a Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from - 01/01/2013 0 SCHEDULEE , SEE INSTRUCTIONS ON REVERSE through 06/30/2013 Page i t of NAME OF FILER I.D. NUMBER 0\ V\/\ 1299779 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW 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' r 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sonoma County Democratic Central Committee, FPPC #742474 701 2nd Street CTB 150.00 Santa Rosa, CA 94404 Mike McGuire for Sonoma County Supervisor, FPPC #1319351 P.O. Box 2095 CTB 100.00 Windsor, CA 95492 Community Institute of Psychotherapy 1330 Lincoln Avenue, Suite 201 CVC 100.00 San Rafael, CA 94901 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 350.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 5719.00 2. Uniternized payments made this period of under $100 .......................................................................................................................................... $ 144.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 0.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 5863.00 FPPC Form 460 (January -/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedgee E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME O�.QLER I N (a Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 through 06/30/2013 (9 SCHEDULE E (CONT.) ) ell t of ,\ 4 Page _-SL son" I.D. NUMBER 1299779 _._1 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 MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PEI- 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 LfT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Boyg& Girls Club of Marin/Southern Sonoma 203 Maria Drive CVC 85.00 Petaluma, CA 94954 Next Generation Consulting 1814 Franklin Street, Suite 510 WEB 150.00 Oakland, CA 94612 The Club at McInnis Park 350 Smith Ranch Road FND 408.00 San Rafael, CA 94903 Committee for Quality San Rafael Schools, FPPC #1355774 369 Third Street, Unit B, #337 CTB 200.00 San Rafael, CA 94901 U.S. Postal Service 40 Bellam Boulevard LIT 277.00 San Rafael, CA 94901 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1120.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) ScheRe E 0 (Continuation Sheet) Type or print in ink. Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE CNS NAME OF FILER Statement covers period from 01/01/2013 through 06/30/2013 SCHEDULE E (CONT.) Page of I.D. NUMBER 129 9779 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW 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 ND independent expenditure supporting/opposing others (explain)* K)S, postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Office Depot 869 Francisco Blvd. W. OFC 312.00 San Rafael, CA 94901 Next Generation Consulting 1814 Franklin Street, Suite 510 CNS 3000.00 Oakland, CA 94612 Costco Food for Event 300 Vintage Way FND 239.00 Novato, CA 94945 Trader Joe's Food for Event 337 Third Street FND 115.00 San Rafael, CA 94901 United Markets Food for Event 515 Third Street FND 201.00 San Rafael, CA 94901 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Sche'aQue E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF�ILER C, V\/) VV\ ' � v� 011 40 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/01/2013 through 06/30/2013 SCHEDULE E (CONT.) � IN 1I Page of I.D. NUMBER 1299779 CODES: If one of the following codes accurately describes 4e payment, you may enter the code. Otherwise, describe the payment. CW 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 LFT campaign literature and mailings PRT print ads WEB information technoloqy costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Terri De Langis San Rafael, CA 94903 FND Entertainment for Event 250.00 Click N Pledge 12202 Airport Way Suite 100 Broomfield, CO 80021 WEB 132.00 ION FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)