HomeMy WebLinkAboutForm 460 - Police Association PAC (2016-09-24)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 0 7 /01 /2016
through _..::0..::.9.<.../::.24-"'/'-'2::..;0:..:1:..:6'--__ _
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
o Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall
(Also Complete Part 5)
lliI General Purpose Committee
® Sponsored o Small Contributor Committee o Political Party/Central Committee
3. Committee Information
COMMITTEE NAME NAME IF
o Primarily Formed Ballot Measure
Committee o Controlled o Sponsored
(Also Complete Part 6)
o Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO P.O . 80X)
1520 Fifth Avenue
CITY STATE ZIP CODE
San Rafael CA 94901
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
P.O. Box 151557
CITY
San Rafael
OPTIONAL : FAX / E·MAI L ADDRESS
4. Verification
STATE
CA
ZIP CODE
94915-1557
AREA CODE/PHONE
(4l5)485-3000
AREA CODE/PHONE
Date of election if applicable:
(Month, Day, Year) SEP 2 9
COVER PAGE
82
06/07 /2016 CITY CLERK'S
2. Type of Statement:
00 Preelection Statement o Semi-annual Statement o Termination Statement
(Also file a Form 410 Termination)
o Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Ms. Beth Minka
MAILING ADDRESS
1520 Fifth Avenue
CITY
San Rafael
NAME OF ASSISTANT TREASURER , IF ANY
Ms. Stacy E. Owens
MAILING ADDRESS
5940 College Avenue
CITY
Oakland
OPTIONAL: FAX / E-MAIL ADDRESS
STATE
CA
STATE
CA
o Quarterly Statement o Special Odd-Year Report o Supplemental Preelection
Statement -Attach Form 495
ZIP CODE
94901
ZIP CODE
94618
AREA CODE/PHONE
(415)485-3000
AREA CODE/PHONE
(510)652-1000
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowle
under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
d herein and in the attached schedules is true and compl ete. I ce rtify
Executed on 09/29/2016
Dale
Executed on 09/29/2016
Dale
Executed on
Dale
Executed on
Date
www.netfile.com
By ____________ ~~~~~~~~~~~~~=_------------------
By __________ ~~~~~~~~~~~~~~ __ ~ __ ~------------
Signature of Controlling Officeho lder, Cand ldale, Slate Measure Proponent
By __________ ~~~~~~~~~~~~~~~~ __ ~------------
S'gnalure or Controlling Officeholder, Candidale, Slate 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)
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Ustanycommittees
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.
COMMITIEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITIEE?
DYES o NO
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITIEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITIEE?
DYES o NO
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
www.nE!tfilE!.com
COVER PAGE -PART 2
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO . OR LETIER JURISDICTION o SUPPORT o 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 Ust names of
officeholder(s) or candidate(s) for which this committee is primarily formed,
NAME OF OFF ICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUMMARY PAGE Campaign Disclosure Statement
Summary Page Amounts may be rounded
to whole dollars. Statement covers period CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
Contributions Received
1. Monetary Contributions ..... ............... ............ ... ........ Schedule A. Une 3 $
2. Loans Received .......... ............... .............. ............... Schedule B. Une 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Unes 1 + 2 $
4. Nonmonetary Contributions .................................... Schedule C. Une 3
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Unes 3 + 4 $
Expenditures Made
6. Payments Made ........... ......... ... .......... .... .... ......... ..... Schedule E. Une 4 $
7. Loans Made ............................................................. Schedule H. Une 3
8. SUBTOTAL CASH PAYMENTS .................................... AddUnes6+7 $
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Une 3
10. Nonmonetary Adjustment .......................................... Schedule C. Une 3
11. TOTAL EXPENDITURES MADE ................................ Add Unes 8 + 9 + 10 $
Current Cash Statement
12 . Beginning Cash Balance ....................... Previous Summary Page. Une 16 $
13 . Cash Receipts .... ................................... ........ .... Column A. Une 3 above
14. Miscellaneous Increases to Cash ........................... Schedule I. Une 4
15. Cash Payments . .............. ....... ................... ......... Column A. Une 8 above
16. ENDING CASH BALANCE .......... Add Unes 12 + 13 + 14. then subtract Une 15 $
If this is a termination statement. Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule B. Part 2 $
Cash Equivalents and Outstanding Debts
18 . Cash Equivalents ........................................ See ins/ructions on reverse $
19. Outstanding Debts.... ............... ...... Add Une 2 + Une 9 in Column B above $
www .np.Hilp..~nm
fiom 07/01/2016
through _---=0..::.9:..../2=-4=..!/...:2:...:0.:;;1.;::.6 __ _ Page 3 of 83
ColumnA
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
ColumnB
CALENDAR YEAR
TOTAL TO DATE
5,785.41 $
0.00
19,290.81
0.00
5 ,785.41 $
0.00
19,290.81
0.00
5,785.41 $ 19,290.81
2.114.39 $
0.00
6.077.21
0.00
2.114.39 $
0.00
6,077.21
0.00
0.00 0.00
2.114.39 $ 6,077.21
46.268.34
5,785.41
0.35
2.114.39
49.939.71
0.00
0.00
0.00
To calculate Column B. add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts . If this is
the first report being filed
for this calendar year. only
carry over the amounts
from Unes 2, 7, and 9 (if
any).
I.D. NUMBER
831553
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ ____ _ $-----
21 . Expenditures
Made $ ____ _ $-----
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made·
(If Subject to Voluntary Expenditure Limit)
Date of Election
(mmldd/yy)
---.1---.1 __
Total to Date
$-----
$-----
• Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
07/15/2016 Elisha Adams
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Elisha Adams
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016 Elisha Adams
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association,
08/31/2016 Elisha Adams
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael, CA 94901
E11s a A ams
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association,
Schedule A Summary
1. Amount received this period -itemized monetary contributions.
CODE *
!!lIND
oCOM
DOTH
oPTY
oscc
OOIND
oCOM
DOTH
oPTY
oscc
!!lIND
DCOM
DOTH
DPTY
oscc
OOIND
DCOM
DOTH
DPTY
OSCC
!!lIND
oCOM
DOTH
oPTY
OSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through 09/24/2016
SCHEDULE A
CALIFORNIA 460
FORM
Page _-"4'---_ of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30
15.30
15.30
16.30
16.31
262 .11
262.11
262.11
262.11
262.11
·Contributor Codes
IND -Individual
(Include all Schedule A subtotals.) ........................................................................................................ $ ___ --'5"-','-=5.=.53::..;.:..::2=..1 COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY -Political Party 2. Amount received this period -unitemized monetary contributions of less than $100 ............................. $ ____ --=2:..::3-=2..:...=.20_=_
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ ___ --=-5 ,:....:7...::.8.=..5.:...;.4=1
www.netfi/e.com
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Raul Aguilar
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Raul Aguilar
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association.
08/15/2016
08/31/2016
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or seC)
OTH -Other (e .g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
OOIND
OCOM
DOTH
OPTY
OSCC
!!lIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
oscc
OOIND
OCOM
DOTH
OPTY
OSCC
!!lIND
OCOM
DOTH
OPTY
OSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTALS
Statement covers period
from 07/01/2016
through _-,0:..::9.!.../.::.2."-'4 /,-,2::..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
I CALIFORNIA 460
FORM
Page_-=-5_ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262 .10
15 .30 262 .10
16.30 262 .10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF· EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Anthony Augustyn
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Anthony Augustyn
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
08/15/2016
08/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
!&lIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRlIND
DCOM
DOTH
DPTY
DSCC
IRlIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period I
from 07/01/2016
through __ 0::.:9"'/c.:2:..4:.!/c.:2:.;0;.:1;.:6'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page_--=.6_ of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262 .10
15.30 262 .10
16.30 262 .10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAMEOFFILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER J.D . NUMBER) CODE *
07 15/2016 James Bellamy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 James Bellamy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
09 15 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
lRJlND
OCOM
DOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
OPTY
DSCC
IRJIND
OCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:.::9.!./.=2.::.4 /,-,2::.:0:.::1:.:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_---=-7_ of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DAlE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUS INESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Kelly Benitez
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Kelly Benitez
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016 Kelly Benitez
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152 ' v n R 4 1
08/31/2016 Kelly Benitez
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ke y Benl.tez
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·Contributor Codes
INO -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g .• business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
IRJINO
DCOM
DOTH
DPTY
DSCC
IRJINO
DCOM
DOTH
DPTY
DSCC
IRJINO
DCOM
DOTH
DPTY
DSCC
IRJINO
DCOM
DOTH
DPTY
DSCC
IK]INO
DCOM
DOTH
DPTY
DSCC
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9.!..../.::.24..:.;/c..:2:..:O:..::1:..::6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page _--,,-8 _ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 155 .00
15.30 155.00
15.30 155 .00
16.30 155 .00
16.30 155.00
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE, ALSO ENTER 1.0. NUMBER)
07/15/2016 Todd Berringer
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Todd Berringer
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
08/15/2016
08/31/2016
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Conlributor Committee
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
OSCC
OOIND
DCOM
DOTH
OPTY
OSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through ___ 0~9~/~2~4~/~2~0~1~6 ____ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--=-9_ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
16.30 262 .10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016
07/29/2016
Lynne Bracken
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Lynne Bracken
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
06/15/2016 Lynne Bracken
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
F'f h Av San R f A 4
06/31/2016 Lynne Bracken
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
09 15 2016 Lynne Brac en
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Recor s
City of
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:..:9,-,/-=2:...4..:./_2....:0_1-=6 __ _
SCHEDULE A (CO NT.)
I CALIFORNIA 460
FORM
Page 10 of 63
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
12.70 205 .40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Antonette Bullock
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Antonette Bullock
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
interm7diary: San Rafael Police Association,
08/15/2016 Antonette Bullock
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
i ntermediary : San Rafael Police Association,
. v n R f el
08/31/2016 Antonette Bullock
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
09 15 2016 Antonette Bu oc
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
i nterm7d i ary: San Rafael Police Association ,
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g ., business entity)
PTY -Political Party
SCC -Small Conlributor Committee
www.netfile.com
OOIND
OCOM
DOTH
DPTY
OSCC
OOIND
OCOM
DOTH
DPTY
DSCC
OOIND
OCOM
DOTH
DPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
DSCC
OOIND
OCOM
DOTH
OPTY
OSCC
Community Service Officer
City of San Rafael
Community Service Officer
City of San Rafael
Community Service Officer
City of San Rafael
Community Service Officer
City of San Rafael
Commun1ty Serv1ce 0 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _....:0:..::9-'../.:::2-=.4/,-,2::..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
I CALIFORNIA 460
FORM
Page _--=.11=--of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 205.40
12.00 205.40
12 .00 205 .40
12.70 205 .40
12.70 205 .40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DA1E
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Michael Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Michael Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016 Michael Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
12' v S n R f 1 4
08/31/2016 Michael Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ml.c ae Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9.,e./.:;2.:.4 /,-,2~0:..::1:.:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _--::;12~ of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262.10
15.30 262 .10
16.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSOENTER 1.0. NUMBER) CODE *
07/15/2016 Shelly Cade
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Shelly Cade
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
·Contributor Codes
IND-Individual
COM -Recipient Committee
(other than PTY or seC)
OTH -Other (e .g ., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
oeOM
DOTH
oPTY
osee
IRJIND
oeOM
DOTH
oPTY
osee
IKJIND o COM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
oPTY
Dsee
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
D~spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9-,-/.::.2,.:.;4 /'-.:2:..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 13 of 83
I.D .NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 205 .40
12.00 205.40
12.00 205 .40
12.70 205.40
12.70 205.40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Joseph Camins
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Joseph Camins
OB/15/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
Fifth
OB/31/2016 Joseph Camins
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
09 15 2016 Josep Caml.ns
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
'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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _...:0:..::9.!../.::.2."-'4 /,-,2::..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 14 of B3
to. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262.10
15.30 262 .10
16.30 262.10
16.30 262.10
7B.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE, ALSO ENTER 1.0 . NUMBER)
07/15/2016 Trevor Carney
C/O: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Trevor Carney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
06/15/2016 Trevor Carney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152' v n n R f el CA 4
08/31/2016 Trevor Carney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
09 15 2016 Trevor Carney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
·CDntributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or seC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
SUBTOTALS
Statement covers period
from 07/01/2016
through _-=0:.:9:.!../.::2..:.4 /!....:2:..:0:.:1:.:6~ __
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--:;15=--of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 246.80
15.30 246.60
15.30 246 .60
16.30 246.80
16.30 246.60
76.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DA1E
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Jack Carpenter
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Jack Carpenter
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
·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
www.nE.!tfilf!.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period I
from 07/01/2016
through __ 0::.;9"'/c..:2:..4:..</....:2:..:0:..:1:..:6'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page_-=-16=--of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 262 .10
15.30 262 .10
15 .30 262.10
16.30 262.10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITIEE. ALSO ENTER 1.0. NUMBER)
07/15/2016 David Casalnuovo
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 David Casalnuovo
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
IRJIND
OCOM
OOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
OOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
OOTH
OPTY
OSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--,0:.,;:;9.:../.=2..::.4/,-,2::..;0:..;:1:..;:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _-=-17.!..-of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262 .10
15.30 262.10
16.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DAlE
RECEIVED
FULL NAME . STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Edward Chiu
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Edward Chiu
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016 Edward Chiu
C/o: San Rafael Police Association 1520 Fifth
08/31/2016
·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
www.netfile.com
94901
Fifth
Fifth
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=O:..::9.!..../.::.24~/~2:..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 18 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 • DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262.10
15.30 262 .10
16.30 262 .10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED . ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSO ENTER I.D. NUMBER) CODE *
07/15/2016 Robert Cleland
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Un i on member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Robert Cleland
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Assoc i ation,
08/15/2016
08/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
OOIND
OCOM
DOTH
OPTY
OSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through_-'O:..:9C!./-=2..::.4.:../:;.2.:.;01::..6"--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--=.1::..9_ of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 262 .10
15.30 262.10
15 .30 262 .10
16.30 262.10
16.30 262.10
78 .50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Christopher Coale
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Christopher Coale
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
fR]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through_--=O:..:9~/.::2.::4!..../=-2.::.c01=.c6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 20 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 262 .10
15.30 262.10
15 .30 262 .10
16.30 262.10
16.30 262 .10
78.50 1
FPPC Form 460 (JanI2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE.ALSO ENTER 1.0. NUMBER)
07/15/2016 Ryan Cogbill
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Ryan Cogbill
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
OB/15/2016
08/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
!X]IND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=0c::9.!../.::.24..::.c/c..:2:..:0c::l:...:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 21 of B3
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 245 .80
15.30 245 .80
15 .30 245 .BO
16.30 245.80
15.30 262.10
77 .501
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Assoc i ation Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN IND)VIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
07/29/2016 Thomas Collins
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
08/15/2016 Thomas Collins
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association,
08/31/2016
09/15/2016
07 15 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND o COM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Off i cer
City of San Rafael
Officer
City of San Rafael
Co mmun~cat~ons D~spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,O:..:9'-'./-=2..::4!..../::.2 0:::.:1:::.:6=--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--".22,,--of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
()F REQUIRED)
15 .30 262.10
15.30 262.10
16.30 262 .10
16.30 262 .10
12 .00 133.40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSOENTERI.O.NUMBER) CODE *
07/29/2016 Jenna Cotta
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
08/15/2016 Jenna Cotta
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/31/2016
09/15/2016
07 15 2016
·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
www.netfile.com
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
!KlIND
DCOM
DOTH
DPTY
DSCC
!KlIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0c::9.!.../.::.24.::.;/,-,2:..:0c::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 23 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 133.40
12.00 133.40
12.70 133.40
12.70 133.40
15.30 262.10
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
IIFCOMMITTEE.ALSOENTER I.D. NUMBER) CODE *
07/29/2016 Ryan De Marta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
08/15/2016 Ryan De Marta
08/31/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
Fifth
09/15/2016 Ryan De Marta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ange a De nevo
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Commun1cat1ons D1spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,O:..:9C!./-=2:..:4!..../=.2.::.:0 1=-6=---__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 24 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 262.10
15.30 262.10
16.30 262.10
16.30 262 .10
12.00 156.00
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
07/15/2016 Christian Diaz
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Christian Diaz
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
09/15/2016
09/31/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:.:9C!./-=2:.:4.!.../.:.;2.:.;0 1::.6"--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 25 of 93
I.D .NUMBER
931553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262.10
15.30 262.10
16.30 262.10
16.30 262 .10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
IIFCOMMITTEE. ALSO ENTER 1.0. NUMBER)
07/15/2016 Christopher Duncan
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Christopher Duncan
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
08/15/2016
08/31/2016
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or seC)
OTH -Other (e .g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
CODE *
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o J.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=0:..::9-,-/.:;.24.::./:....:2:..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 26 of 83
I.D .NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262 .10
15.30 262.10
15.30 262 .10
16.30 262 .10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
07/15/2016 Scott Eberle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/29/2016 Scott Eberle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
08/15/2016
08/31/2016
09 15 2016
·Contributor Codes
INO-Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g .• business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOINO
DCOM
DOTH
DPTY
DSCC
OOINO
DCOM
DOTH
DPTY
DSCC
!R]INO
DCOM
DOTH
DPTY
DSCC
!R]INO
DCOM
DOTH
DPTY
DSCC
!R]INO
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--,0..:,9.:.../_2--,4/,-2_0_1_6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 27 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 262_10
15.30 262.10
15.30 262 .10
16.30 262.10
16.30 262_10
78_5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
07/15/2016 Ami Esparza
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Christopher Fuller
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Communications Dispatcher
City Of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:..:9:...:/....:2:..;4:..:./-=2:..:0-=1:..:6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 28 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 144.00
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016
07/15/2016
07/29/2016
Christopher Fuller
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Salvatore Garanzini
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1 2 Fifth Av n Raf 1
08/15/2016 Salvatore Garanzini
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Sa vatore Garanz~n~
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary : San Rafael Police Association,
·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
www.netfile.com
OOIND
OCOM
DOTH
OPTY
OSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
OSCC
Police Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through_-'0"'9..:../-'..2-'.4.!../_2-'-01_6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--=-2:<...9_ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15 .30 262.10
15.30 262 .10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Salvatore Garanzini
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Michael Garrison
c/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Michael Garrison
c/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
Fif Av an R fa 1 CA
08/15/2016 Michael Garrison
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
M~c ae Garr~son
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY Dr SCC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0_9..:../_2_4:..../2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_-=.30,,--of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15 .30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DAlE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSOENTER LD. NUMBER) CODE *
09/15/2016 Michael Garrison
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Lilah Gavlick
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Lilah Gavlick
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1 2 Fifth A n Raf 1 4
08/15/2016 Lilah Gavlick
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
L~ a Gav ~c
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
SUBTOTAL $
SCHEDULE A (CO NT.)
Statement covers period
I CALIFORNIA 460
, FORM from 07/01/2016
through __ 0:..;:9-,/...;:2,-,4,",-/_2...;.0_1_6 __ _ Page 31 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC , 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16 .30 262 .10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
09/15/2016
07/15/2016
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER)
Lilah Gavlick
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Justin Graham
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016 Justin Graham
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1 20' v n R f 1
08/15/2016 Justin Graham
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Just~n Gra am
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
'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
www.netfile.com
CODE *
IKJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
DPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
Police Officer
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0-,-9.!-/_24-,/,-2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 32 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262 .10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLDYED, ENTER NAME
OF BUSINESS)
(IF CDMMITTEE, ALSO ENTER I.D. NUMBER) CODE *
09/15/2016 Justin Graham
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Lori Hendricks
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016 Lori Hendricks
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
Union member's dues received through
intermediary: San Rafael Police Association,
152 F' v n e n Rafael
08/15/2016 Lori Hendricks
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 LorJ. Hen rJ.c s
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
Union member's dues received through
interm~diary: San Rafael Police Association,
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
~IND
DCOM
DOTH
DPTY
DSCC
IXlIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City Df San Rafael
Dispatcher
City of San Rafael
DJ.spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-=0:.:9C!,/-=2..::4!""/::.2 0:::.:1:::.:6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 33 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE , ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Lori Hendricks
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Robert Henkle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
interm~diary: San Rafael Police Association,
07/29/2016 Robert Henkle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
intermediary : San Rafael Police Association,
152 ' v n R f 4 1
08/15/2016 Robert Henkle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fif th Avenue, San Rafael, CA 94901
Ro ert Hen e
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary : San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Dispatcher
Ci ty of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o J.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..;;9..:../.=.2..:..4/,-,2",0:..;;1,-,6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 34 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205 .40
15.30 262.10
15.30 262 .10
15.30 262.10
16.30 262 .10
74.90 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016 Robert Henkle
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 J. Alexander Holm
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0...;.9.:../_24-,/,-2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 35 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262 .10
15 .30 262 .10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, AlSO ENTER 1.0. NUMBER)
09/15/2016 J. Alexander Holm
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Lisa Holton
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary; San Rafael Police Association,
07/29/2016
08/15/2016
08 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE ..
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,O:..:9,"-/.;;;2..=4.!.../=.2.:..0 1=-6=--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 36 of 83
LD.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc,ca,gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Lisa Holton
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Kyle Hornstein
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:.;9:...:/-=2:.:4:..:./-=2:....:0-=1-=6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 37 of B3
1.0. NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
15.30 262 .10
15.30 262 .10
15.30 262 .10
16.30 262.10
7B.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER I.D . NUMBER) CODE *
09/15/2016 Kyle Hornstein
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Carl Huber
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016 Carl Huber
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152 . n R 1 4 1
08/15/2016 Carl Huber
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Car H er
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
·ContributDr CDdes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e .g .• business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-=0:.::9.!..../=-24~/c..:2:..:0:.::1:.::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 38 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETODATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
15.30 262 .10
15.30 262 .10
15.30 262 .10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/20i6)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016 Carl Huber
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Daisy Huerta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
08 31 2016
·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
www.nAtfilA.r.nm
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Call Taker/Records
Specialist
City Of San Rafael
Call Taker/Records
Specialist
City Of San Rafael
Call Taker/Records
Specialist
City Of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0-,-9..:.../_2--,4 /,-2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 39 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
12.00 121. 40
12 .00 121.40
12.00 121. 40
12 .70 121.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Daisy Huerta
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Scott Ingels
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary; San Rafael Police Association,
07/29/2016
08/15/2016
08 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Call Taker Records
Specialist
City Of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:..;9,-,/....;2,-,4;.:./_2,-0_1_6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 40 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 121. 40
15.30 262.10
15 .30 262.10
15 .30 262.10
16.30 262.10
74.90 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO. ENTER NAME
OF BUSINESS)
(IF COMMITIEE. ALSO ENTER I.D. NUMBER)
09/15/2016 Scott Ingels
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Rebecca Jensen
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
OB/15/2016
'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
www.netfile.com
Fifth
Fifth
CODE *
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Recor s
City of
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0_9..:.../_2--,4/,-2_0_1_6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 41 of B3
I.D .NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITTEE.ALSOENTER I.D . NUMBER) CODE *
09/15/2016
07/15/2016
07/29/2016
OB/15/2016
OB 31 2016
Rebecca Jensen
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Lynette Keller
c/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
interm7diary: San Rafael Police Association,
Fifth
Fifth
Fifth
·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
www.netfile.com
!!lIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
Records Clerk
City of San Rafael
Community Service Officer
City of San Rafael
Community Service Officer
City of San Rafael
Community Service Officer
City of San Rafael
Commun1ty Serv1ce 0 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0..:.9-'../_2-,4 /:....2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 42 of B3
I.D .NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12 .70 205 .40
12.00 205.40
12 .00 205 .40
12.00 205 .40
12 .70 205 .40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR )F AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016
07/15/2016
07/29/2016
08/15/2016
Lynette Keller
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Rebecca Kuga
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
Fifth
Fifth
Fifth
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Community Service Officer
City of San Rafael
YSB Supervisor
City of San Rafael
YSB Supervisor
City of San Rafael
YSB Supervisor
City of San Rafael
YSB Supervl.sor
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ ~0~9~/~2~4~/~2~01~6~ __ ___
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 43 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF· EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE, ALSO ENTER to. NUMBER)
09/15/2016 Rebecca Kuga
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Marc Laplante
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
OB/15/2016
OB 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
IR)IND
DCOM
DOTH
DPTY
DSCC
IR)IND
DCOM
DOTH
DPTY
DSCC
IR)IND
DCOM
DOTH
DPTY
DSCC
IR)IND
DCOM
DOTH
DPTY
DSCC
IR)IND
DCOM
DOTH
DPTY
DSCC
YSB Supervisor
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o J.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9..!./.::2..:.4 /'-.:2:..:0:..::1:..::6'----__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 44 of B3
I.D.NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205 .40
15.30 262.10
15.30 262 .10
15.30 262.10
16.30 262.10
74.9°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016 Marc Laplante
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Anndora Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Anndora Lee
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
2 F i hAven S n Raf
08/15/2016 Anndora Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ann ora Lee
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael . CA 94901
Union member's dues received through
interm7diary : San Rafael Police Assoc i ation ,
·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
www.netfile.com
OOIND
DeOM
DOTH
DPTY
osee
OOIND
DeOM
DOTH
DPTY
osee
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
osee
IKJIND
DCOM
DOTH
DPTY
osee
Officer
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
D1spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0c::9.!./.::.24..::.;/,-,2:..:0:..::1:..::6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 45 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
12.00 205.40
12.00 205.40
12.00 205 .40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016
07/15/2016
07/29/2016
Anndora Lee
c/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
Judy Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
Fifth
08/15/2016 Judy Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ju y Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association,
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Dispatcher
City of San Rafael
Records Specialist
City of San Rafael
Records Specialist
City of San Rafael
Records Specialist
City of San Rafael
Recor s
City of
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0_9..:../_2_4-,-/_2_0 1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 46 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
12.00 205.40
12.00 205 .40
12.00 205.40
12.70 205 .40
FPPC Form 460 (Jan/20i6)
FPPC Advice: advice@fppc.ca,gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMIITEE.ALSOENTER 1.0. NUMBER) CODE *
09/15 2016 Judy Lee
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Rogelio Leon
c/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Rogelio Leon
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
152 F' v n n R f e
OB/15/2016 Rogelio Leon
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Roge ~o Leon
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfi/e.com
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DeOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
Dsec
IKJIND
DeOM
DOTH
DPTY
DSCC
Records Specialist
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--,0...:.9..:.../_2--,4/,-2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 47 of B3
I.D.NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
FPPC Form 460 (Jan12016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Rogelio Leon
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Kevin Macdougald
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
OB/15/2016
DB 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
OCOM
DOTH
OPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
Sergeant
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0-'-9-'./_2_4.<../_2-'-01_6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--,=-4,,-B_ of B3
1.0. NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
7B.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SEUF-EMPLOYEO , ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Kevin Macdougald
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Carlos Maldonado
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
08/15/2016
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e .g., business entity)
PTY -Political Party
SCC -Small Conlributor Committee
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o J.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0;.::9.!..../::.24"",/,-,2:;.:0;.::1;.::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 49 of 83
I.D .NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16 .30 262 .10
15.30 262.10
15 .30 262.10
15.30 262.10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Carlos Maldonado
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Michael Mathis
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Michael Mathis
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
F ' Av n R f I 4
OB/1S/2016 Michael Mathis
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ml.c ae Mat l.S
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
'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
www.netfi/e.com
OOIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IXJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0...:.9..:../_2_4.:..../_20_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_-=.S,,-o_ of B3
1.0. NUMBER
B31SS3
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262 .10
15.30 262.10
16.30 262 .10
7B.SOI
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gOY (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Michael Mathis
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Kelly Mauel
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IK]IND o COM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Commun1cat1ons D1spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _...:O:..:9:.!/..:2:.:4:.!/..:2:.:0..:1..:6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 51 of 83
i.D .NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
12.00 205.40
12.00 205 .40
12.00 205 .40
12.70 205 .40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DA1E
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
09/15/2016 Kelly Mauel
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Phillip Melodia
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
'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
www.netfi/e.com
Fifth
Fifth
Fifth
CODE *
[KJIND
OCOM
DOTH
OPTY
OSCC
IK]IND
OCOM
OOTH
OPTY
OSCC
[XlIND
OCOM
DOTH
OPTY
OSCC
[KJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
Communications Dispatcher
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--,0-,,9..:.../_2....;4 /:....2_o_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 52 of 83
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
15.30 262 .10
15.30 262 .10
15.30 262 .10
16.30 262 .10
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF· EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE *
09 15/2016 Phillip Melodia
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Beth Minka
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Administrative Technician
City of San Rafael
Administrative Technician
City of San Rafael
Administrative Technician
City of San Rafael
A m1n1strat1ve Tec 1C1an
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0-,-9..:./_2_4.:.../_2-,-01_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _-=.53~ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Beth Minka
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Lynn Murphy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Lynn Murphy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1 2 Fif h Av n e n R f CA 4 01
08/15/2016 Lynn Murphy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Lynn Murp y
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Administrative Technician
City of San Rafael
Mental Health Outreach
Provider
City of San Rafael
Mental Health Outreach
Provider
City of San Rafael
Mental Health Outreach
Provider
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _....:0:.;:9.!-/=.2.:.;4 /~2:.:0:.;:1:.;:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 54 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOY EO, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE.AL50ENTER 1.0. NUMBER) CODE *
09/15/2016 Lynn Murphy
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Jorge Navarro
07/29/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
Fifth
08/15/2016 Jorge Navarro
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Jorge Navarro
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
[RJIND o COM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Mental Health Outreach
Provider
City of San Rafael
Evidence Technician
City of San Rafael
Evidence Technician
City of San Rafael
Evidence Technician
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9.!../.::.2..::.;4 /,-,2::..:0:..::1:...:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 55 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
12.00 205.40
12.00 205 .40
12.00 205.40
12.70 205.40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Jorge Navarro
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Alexis Nielsen
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association.
07/29/2016
08/15/2016
·Contributor Codes
IND -Individual
COM -Recipient Comm ittee
(other than PTY or SCC)
OTH -Other (e.g ., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Evidence Technician
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lea Commun1cat1ons
Dispatcher
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ ~0~9~/~2~4~/~2~01~6~ __ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page __ --=.56=___ of 83
1.0 . NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12 .70 20 5.40
12.00 205 .40
12.00 205 .40
12.00 205 .40
12.70 205 .40
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
(IFCOMMITIEE.ALSOENTER LD . NUMBER) CODE *
09/15/2016 Alexis Nielsen
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Leslie O'Toole
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016 Leslie O'Toole
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152 Fifth Av n e n Ra 4 0
08/15/2016 Leslie O'Toole
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Les ~e O'Too e
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
·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
www.netfile.com
IX]IND
DCOM
DOTH
DPTY
DSCC
IX]IND
DCOM
DOTH
DPTY
DSCC
IXlIND
DCOM
DOTH
DPTY
DSCC
IX]IND
DCOM
DOTH
DPTY
DSCC
IX]IND
DCOM
DOTH
DPTY
DSCC
Lead Communications
Dispatcher
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0.;..9,-,/,-2_4-,/_2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_-=..57-,--of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12_70 205 -40
15.30 262_10
15.30 262_10
15.30 262_10
16.30 262_10
74_90 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER I.D. NUMBER) CODE *
09/15/2016 Leslie O'Toole
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Brian Patterson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
08/15/2016
08 31 2016
'Contributor Codes
INO -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
I!lIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0_9-,/_2_4-'./_2_0_1_6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 58 of 83
J.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSOENTERI.D.NUMBER) CODE *
09/15/2016 Brian Patterson
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Buffy Paxson
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary; San Rafael Police Association,
07/29/2016 Buffy Paxson
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1 2 Fif hAven n R f 1 4
08/15/2016 Buffy Paxson
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Bu y Paxson
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary; San Rafael Police Association,
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or seC)
OTH -Other (e.g .• business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfi/e.com
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=O:.:9~/.::2..:.4 /<....:2:..:0:.:1:.:6'---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 59 of 83
J.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262,10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DA1E
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER)
09/15/2016 Buffy Paxson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Jessica Perry
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Jessica Perry
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152' v n R f 1
08/15/2016 Jessica Perry
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Jess~ca Perry
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·Contributor Codes
IND -Individual
eOM -Recipient eommiHee
(other than PTY or SCC)
OTH -Other (e.g ., business entity)
PTY -Political Party
see -Small Contributor CommiHee
www.netfile.com
CODE *
!R)IND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
Dsee
!R)IND
DCOM
DOTH
DPTY
Dsee
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0=..;9"-'/'-'2=..;4""'/'-'2:...:0;..=1;..=6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _--".6 0,,---of 8 3
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262 .10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IF COMMITIEE,ALSO ENTER 1.0. NUMBER)
09/15/2016 Jessica Perry
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Aaron Piombo
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
OB/15/2016
OB 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--,O:..:9:..!./-=2c..::4.!.../=2.::..0 1::.6=--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 61 of B3
I.D.NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
7B.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Aaron Piombo
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Allyson Powell
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND o COM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Communications Dispatcher
City of San Rafael
Commun~cat~ons D~spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=O..:.9.!../.:;..24-,-,/,-2-,0 __ 1 __ 6 __ _
SCHEDULE A {CO NT.)
CALIFORNIA 460
FORM
Page 62 of 83
I.D .NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16 .30 262 .10
12.00 205 .40
12 .00 205 .40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOY EO . ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
09 15 2016 Allyson Powell
C/o ; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
intermediary ; San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Dennis Prince
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
07/29/2016 Dennis Prince
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
intermediary ; San Rafael Police Association,
2 Fi th Aven e S n Raf
08/15/2016 Dennis Prince
C/o; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary ; San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Dennl.s Pr1nce
C/o ; San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member 's dues received through
intermediary; San Rafael Pol i ce Association,
·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
www.netfile.com
OOIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
!RIIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
!RIIND
DCOM
DOTH
DPTY
DSCC
Communications Dispatcher
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-=0:..::9~/.::.2~4 /<...:2:..:0:..::1:..::6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 63 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205 .40
15.30 262 .10
15.30 262 .10
15.30 262 .10
16.30 262 .10
FPPC Form 460 (JanI2016)
FPPC Advice: advice@fppc.ca.gov (8661275·3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
09 15/2016 Dennis Prince
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Gino Rantissi
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Gino Rantissi
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152 Fifth Avenue an R f el 4
08/15/2016 Gino Rantissi
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 G~no Rant~ss~
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0:..::9..!./..=2..:.4 ,-,I 2::..:0:..::1:..:6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--=.64-=--of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016 Gino Rantissi
c/o San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Ronda Reese
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0""9;...</...:2,,,,4;.:./...:2...:0...:1...:6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 65 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSOENTER I.D. NUMBER) CODE *
09/15/2016 Ronda Reese
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Peggy Ruge
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
Corporal
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lea Commun~cat~ons
Dispatcher
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0,-,9....:./_2_4-'./_2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _--,,-66,,--of 83
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED . ENTER NAME
OF BUSINESS)
(IF COMMITTEE . ALSO ENTER 1.0. NUMBER) CODE *
09 15 2016 Peggy Ruge
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Thomas Sabido
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael , CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
07/29/2016
08/15/2016
·Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e .g ., bus iness entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Lead Communications
Dispatcher
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City o f San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-'0:.:9'-'../.::2..:.4'-'/2::..:0:..:1:.:6'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 67 of 83
1.0 . NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12 .70 205.40
15.30 262.10
15.30 262 .10
15.30 262 .10
16.30 262.10
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITTEE,ALSO ENTER I.D. NUMBER) CODE *
09/15/2016 Thomas Sabido
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Anthony Scalercio
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfi/e.com
Fifth
Fifth
Fifth
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:..:9:...:/...:2:..:4:..:./..=2:..:0..=1:..::6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 68 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Anthony Scalercio
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 George Schikore
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
08 31 2016
·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
www.netfile.com
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ O:..:9:..!/-=2:...:4:..c/..=2:..:0-=l:..:6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page_--=.6:..9_ of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 George Schikore
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Justin Schraeder
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Justin Schraeder
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1 2 Fifth Av n n R f 4
08/15/2016 Justin Schraeder
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 JustLn Sc rae er
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o Lcer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _""0:.,:9,,,,/.,;;2;,,;4:..<./.,;;2,-,0..::1,-,6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 70 of 83
LD.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16_30 262.10
15_30 262.10
15_30 262_10
15.30 262.10
16_30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER I.D . NUMBER)
09/15/2016 Justin Schraeder
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary : San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Wanda Spaletta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
07/29/2016 Wanda Spaletta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1 20 Fifth Av n R f 1
08/15/2016 Wanda Spaletta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Wan a spa etta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
·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
www.netfile.com
CODE *
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IR]IND
OCOM
DOTH
OPTY
OSCC
IR]IND
OCOM
DOTH
OPTY
OSCC
IR]IND
OCOM
DOTH
OPTY
OSCC
officer
City of San Rafael
sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0..;.9..:../_2_4.:.../_20_1_6'--__
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 71 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262 .10
15.30 262 .10
15.30 262 .10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE. ALSO ENTER I.D. NUMBER)
09/15/2016 Wanda Spaletta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Christopher Sweeney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
!R]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
!R]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
!R]IND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-,0",9.:.../=.24-",/'-.:2::..:0",1",6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 72 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.5°1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
09/15/2016 Christopher Sweeney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Charly Taylor
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association,
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
CODE *
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Civilian Supervisor
City of San Rafael
Civilian Supervisor
City of San Rafael
Civilian Supervisor
City of San Rafael
C1V1 1an Superv1sor
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0,",9,-,/_2_4;.:./...;.2,-,0..=1,-,6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--,-73,,--of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
12.00 205.40
12.00 205.40
12.00 205.40
12.70 205.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
IIFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Charly Taylor
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Henry Tirre
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016 Henry Tirre
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
152 Fif h Av n e S n R f el CA 4
OB/15/2016 Henry Tirre
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
OB 31 2016 Henry T~rre
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IKJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
Civilian Supervisor
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0.;..9,-,/,-2_4-,/_2_0_1_6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 74 of B3
I.D.NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 205.40
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED . ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) CODE *
09/15/2016 Henry Tirre
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary: San Rafael Police Association.
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Michael Vergara
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
interm~diary: San Rafael Police Association.
07/29/2016
08/15/2016
·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
www.netfile.com
Fifth
Fifth
Fifth
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
IKIIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _-=0:..::9..!.../.=.2..:.;4 /~2:.:0:.:1:..::6:...-__
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 75 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
78.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEo, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Michael Vergara
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Anna Warren
07/29/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
Fifth
08/15/2016 Anna Warren
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
08 31 2016 Anna Warren
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
·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
www.netfile.com
IR]IND
DCOM
DOTH
OPTY
OSCC
[RJIND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
DPTY
DSCC
IR]IND
OCOM
DOTH
OPTY
OSCC
IKJIND
OCOM
DOTH
OPTY
OSCC
Sergeant
City of San Rafael
Dispatcher
City Of San Rafael
Dispatcher
City Of San Rafael
Dispatcher
City Of San Rafael
Dl.spatc er
City Of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
,
through _-'0:..::9-'../.::.2.:,;4/'-'2:..:0:..:1:..::6'---__
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 76 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
12.00 193.40
12.00 193.40
12.00 193.40
12.70 193.40
65.001
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED. ENTER NAME
OF BUSINESS)
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
09/15/2016 Anna Warren
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary: San Rafael Police Association.
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Mark Wilkinson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association.
07/29/2016 Mark Wilkinson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary: San Rafael Police Association.
152 Fif h Av n e n R f el 4 05
08/15/2016 Mark Wilkinson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary: San Rafael Police Association.
1520 Fifth Avenue. San Rafael. CA 94901
Mar W~ ~nson
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association.
·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
www.netfile.com
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
OSCC
IRJIND
OCOM
DOTH
DPTY
DSCC
Dispatcher
City Of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through __ 0:..:9,-,/...:2:..:4,-,/...:2:....:0:..;:1:..;:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 77 of 83
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.70 193.40
15.30 262.10
15.30 262.10
15.30 262.10
16.30 262.10
74.90 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
09/15/2016 Mark Wilkinson
C/o : San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
07/15/2016 Bianca Wilmott
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
07/29/2016
OB/15/2016
OB 31 2016
·Conlributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e .g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfi/e.com
Fifth
Fifth
Fifth
CODE *
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
SUBTOTAL $
Statement covers period
from 07/01/2016
through _--=O:..::9-,-/.::.2..oc4/c..:2:..:0:..:1:..:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 7B of B3
I.D.NUMBER
B31553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 262.10
15.30 246 .BO
15.30 246.BO
15.30 246 .BO
16.30 246.BO
7B.5 ol
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.goy (866/275-3772)
www.fppc.ca.goY
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYED, ENTER NAME
OF BUSINESS)
(IF COMMITIEE. ALSO ENTER 1.0 . NUMBER)
09/15/2016 Bianca Wilmott
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
·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
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CODE *
IRJIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
Police Officer
City Of San Rafael
SUBTOTAL $
SCHEDULE A (CO NT.)
Statement covers period CALIFORNIA 460
FORM from 07/01/2016
through _-,0:..=9..!../.::.2."-'4/,-,2::..;0:..=1:..=6 __ _ Page 79 of 83
I.D.NUMBER
AMOUNT
RECEIVED THIS
PERIOD
831553
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
16.30 246.80
16.3°1
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
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
DATE NAME OF CANDIDATE. OFFICE. AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION.
OR COMMITTEE
09/20/2016 Sheila Lichtblau
Superior Court Judge
Marin County. CA
[!) Support
o Support
o Support
Schedule D Summary
o Oppose
o Oppose
o Oppose
Amounts may be rounded
to whole dollars.
TYPE OF PAYMENT
0 Monetary
Contribution
0 Nonmonetary
Contribution
0 Independent
Expenditure
0 Monetary
Contribution
0 Nonmonetary
Contribution
0 Independent
Expenditure
0 Monetary
Contribution
0 Nonmonetary
Contribution
0 Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
SUBTOTAL $
SCHEDULE 0
Statement covers period
from 07/01/2016
through 09/24/2016 Page 80 of 83
AMOUNT THIS
PERIOD
1.000.00
1.000 .001
I.D. NUMBER
831553
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
1.000.00 2016 $1.000.00
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals .) ........................................... $ ___ ....::1::..L.~0~00~.:..!:0~0
2. Unitemized contributions and independent expenditures made this period of under $100 ................................................................................. $ _____ -'0::.,;.:..;:0:,;:.0
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............. TOTAL $ ____ 1...:.._0_00_._0_0
www.netfile.com FPPC Form 460 (Janf2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE E
ScheduleE
Payments Made Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2016
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE th rough _-'0..:.9..:../.=2..:.4'-./::.20::.c1::.c6=--__ Page _8_1_ of _8_3_
NAME OF FILER 1.0. NUMBER
San Rafael Police Association Political Action Committee 831553
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
OIIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD retumed contributions
CTB contribution (explain nonmonetary)· OFC office expenses SAL campaign workers' salaries
CVC civic donations PEr petition circulating 1B... t.v. or cable airtime and production costs
FIL candidate filing/ballot fees A-K) phone banks THC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research THS staff/spouse travel, lodging, and meals
1110 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 VIIB3 information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Donor Stack, LLC WEB 48.95
5940 College Avenue, Suite F
Oakland, CA 94618
Donor Stack, LLC WEB 75.74
5940 College Avenue, Suite F
Oakland, CA 94618
Friends of Sheila Lichtblau for Judge 2016 (ID# 1384235) CTB 1,000.00
35 Miller Avenue # 274
Mill Valley, CA 94941
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,124.69
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ ___ --=-2!.., 1:..:1:...:4:..:.-=3.::..9
2. Unitemized payments made this period of under $1 00 .......................................................................................................................................... $ _____ -'0e..:.C!:0~0
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ _____ ....:0:...:.C!:0c.::.0
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ ___ -=2,!.., ::.:1l::.:4:...:.:..:3~9
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FPPC Form 460 (Jan/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
SCHEDULE E (CONT.)
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2016
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through 09/24/2016 Page __ 82_ of_8_3_
NAME OF FILER I.D.NUMBER
San Rafael Police Association Political Action Committee 831553
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
OJP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD retumed contributions
CTE contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries
CVC civic donations FEr petition circulating TB.. t.v. or cable airtime and production costs
RL candidate filing/ballot fees PHD phone banks me candidate travel, lodging, and meals
FND fundraising events POL polling and survey research ms 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 IJVB3 information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE CODE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
The Henry Levy Group PRO
5940 College Avenue
Oakland, CA 94618
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D.
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OR DESCRIPTION OF PAYMENT AMOUNT PAID
989.70
SUBTOTAL $ 989.70
FPPC Form 460 (Jan/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE . ALSO ENTER 1.0 . NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2016
through 09/24/2016
DESCRIPTION OF RECEIPT
SUBTOTAL $
1. Itemized increases to cash this period ........................................................................................................................ $ _____ o;:,;.:....:oc::,o
2. Unitemized increases to cash of under $1 00 this period ............................................................................................. $ _____ 0.:.....:....:3~5
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ _____ o;:,;.:....:0c.::.0
4 . Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ........................................................................................................................... TOTAL $ _____ 0;:,;.:....:3c.::.5
SCHEDULE I
CALIFORNIA 460
FORM
Page __ 83_ of __ 83_
I.D.NUMBER
831553
AMOUNT OF
INCREASE TO CASH
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FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov