HomeMy WebLinkAboutForm 460 - Police Association PAC (2016-06-30)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from OS/22/2016
through _--=0:..::6"-/.::3.::.0'-/2=-0::..;1::..:6=---__ _
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2,3, and 4.
D Officeholder, Candidate Controlled Committee D Primarily Formed Ballot Measure o State Candidate Election Committee Committee o Recall 0 Controlled
(Also Complele Part 5) 0 Sponsored
(A/so Complete Part 6)
[X] General Purpose Committee
® Sponsored o Small Contributor Committee o Political PartylCentral Committee
3. Committee Information
MITTEE NAME (OR CANDIDATE'S
D Primarily Formed Candidatel
Officeholder Committee
(Also Complete Part 7)
I.D. NUMBER
831553
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO P.O. BOX)
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 STATE ZIP CODE
San Rafael CA 94915-1557
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
(415)485-3000
AREA CODE/PHONE
2. Type of Statement:
D Preelection Statement
[X] Semi-annual Statement
D Termination Statement
(Also file a Form 410 Termination)
D 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
COVER PAGE
D Quarterly Statement
D Special Odd-Year Report
D 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 knowledge th
under penalty of pe~ury under the laws of the State of California that the foregoing is true and correct.
Executed on 07/24/2016
Dale
Executed on 07/24/2016
Dale
Executed on
Dale
Executed on
Dale
www.netfile.com
By ________ ~;---~~~~~~~~~~~~-----------------
By _________ ~~~~~~~~~~~~~~--~--~------------Signature of Controlling Officeholder, Candidale, Slate Measure Proponent
By _________ ~~~~~~~~~~~~~~~~~~------------Signature of Controlling Officeholder, Candidate, 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.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O . BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O . BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
www.netfile.com
•• ~C,O~VIjjEIIR PAGE -PART 2
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION D SUPPORT
D 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 Ustnames of
officeho/der(s) or candidate(s) for which this committee is primarily formed.
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
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, Line 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 .................................... Add Unes 6 + 7 $
9 . Accrued Expenses (Unpaid Bills) ............................... Schedule F. Une 3
10. Nonmonetary Adjustment .......................................... Schedule C, Une 3
11. TOTAL EXPENDITURES MADE ................................ Add Lines B + 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 B above
16. ENDING CASH BALANCE .......... Add Unes 12 + 13 + 14, then subtract Une 15 $
If this is a termination statement. Une 16 must be zero.
17 . LOAN GUARANTEES RECEIVED ...... ..................... Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18 . Cash Equivalents ........................................ See instructions on revef5e $
19 . Outstanding Debts ......................... AddUne2+Une9inCofumnBabove $
www.netfile.com
from OS/22/2016
through __ 0_6.:..../3_0-,/_2_0_1_6 __ _ Page _-=3__ of 50
ColumnA
TOTAL THIS PER IOD
(FROM ATTACHED SCHEDULES)
ColumnB
CALENDAR YEAR
TOTAL TO DATE
3,359.10 $
0 .00
13 ,505 .40
0 .00
3,359.10 $
0.00
13,505 .40
0.00
3,359.10 $ 13,505.40
99.27 $
0 .00
3,962.82
0.00
99 .27 $ 3,962.82
0.00 0 .00
0 .00 0.00
99.27 $ 3,962.82
43,007.80
3,359.10
0 .71
99 .27
46,268 .34
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 Lines 2, 7, and 9 (if
any).
1.0 . 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 Umlt)
Date of Election
(mm/dd/yy)
----1----1 __
Total to Date
$-----
$-----
·Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Janl2016)
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) CODE *
05/31/2016 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,
06/15/2016 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,
06/30/2016 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,
05/31/2016 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
06 15 2016 Raul Agu~lar
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.
[!]IND
DCOM
DOTH
DPTY
DSCC
[!]IND
DCOM
DOTH
DPTY
DSCC
[!]IND
DCOM
DOTH
DPTY
DSCC
[!]IND
DCOM
DOTH
DPTY
DSCC
[!]IND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
I
through 06/30/2016
SCHEDULE A
CALIFORNIA 460
FORM
Page _-,4,--_ of 50
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
15.30
15.30
15.30
15.30
76.50 1
183.60
183.60
183.60
183.60
183.60
·Contributor Codes
IND -Individual
(Include all Schedule A subtotals.) ........................................................................................................ $ ___ .::..3 ~, 1.::..98,,-,.'-".6,,-0 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 ............................. $ _____ .::.1::..60::..:..:. 5::,:0:..
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ ____ 3 ,-,3_5_9 _.1_0
www.netfile.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 COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
06 30/2016 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
05/31/2016 Anthony Augustyn
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
06/30/2016
05 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
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
Sergeant
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6..:../_3_0-,-/_2_01_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page __ 5==--_ of 50
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 *
06/15/2016 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
06/30/2016 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,
05/31/2016
06/15/2016
·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
IRJINO
DeOM
DOTH
DPTY
Dsec
IRJINO
DCOM
DOTH
DPTY
osee
IRJINO
OCOM
DOTH
DPTY
Dsee
IRJINO
DeOM
DOTH
OPTY
osce
IRJINO
DeOM
DOTH
DPTY
Dsee
Corporal
City of San Rafael
Corporal
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _~0:..::6,,-/.::.3.::.0 /,-,2:..:0:..::1:..::6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page _-=-6 _ of 5 °
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15 .30 183.60
15.30 183.60
15.30 183.60
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.
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 *
05 31 2016
06/15/2016
06/30/2016
05/31/2016
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,
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,
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
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Records Clerk
City of San Rafael
Community Service Officer
City of San Rafael
Commun~ty Serv~ce 0 ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6...!./_3_0..:../_2_0 1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_--,-7_ of 50
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
12.00 144.00
12.00 144.00
12.00 144.00
12.00 144.00
60.001
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)
(IFCOMMITTEE,ALSOENTER 1.0. NUMBER) CODE *
06 30 2016 Antonette Bullock
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union memher's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue San Rafael CA 94901
05/31/2016 Michael Byers
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union memher's dues received through
interm7diary: San Rafael Police Association,
06/15/2016
06/30/2016
·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
IR]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Community Service Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
DJ.spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6..!-/-,-3-,-,0 /,---2_0,---1-=-6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _--=-8 _ of 50
LD. 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
15.30 183.60
15.30 183.60
15.30 183.60
12.00 144.00
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)
(IF COMMITTEE , ALSO ENTER 1.0. NUMBER) CODE *
06/15/2016 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
06/30/2016 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,
05/31/2016 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,
1 F'f h Av n n R f 1 4 01
06/15/2016 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
06 30 2016 Josep Cam~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
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
City of San Rafael
Dispatcher
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 OS/22/2016
through _--=O:.:6,,-/.::.3.::.0!...:/ 2:..:0:.:1:.:6'----__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_---"-9_ of 50
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
12.00 144.00
15.30 183.60
15.30 183.60
15.30 183.60
69.90 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 COMMITTEE . ALSO ENTER 1.0. NUMBER) CODE *
05/31/2016 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
06/15/2016 Trevor Carney
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
06/30/2016 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 Av n n R f 1 4 01
05/31/2016 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
Jac 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,
·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
OOIND
DCOM
DOTH
DPTY
DSCC
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
Officer
City of San Rafael
o l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _--=0:...::6-,-/.=.3..:..0 /c..:2::..:O:...::1:...:6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 10 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 168.30
15.30 168.30
15.30 168.30
15.30 183.60
15.30 183.60
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.
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 *
06 30 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
05/31/2016 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,
06/15/2016 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,
152 Fifth Av n e S n R fael CA 4 1
06/30/2016 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
E war C l.U
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
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 l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,0:.:60!./.::.3.::.0!.../=.2 =.;0 1=.;6=---__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _---=.1 =-1 _ of 5 °
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15 .30 183.60
15.30 183.60
15.30 183.60
76.5°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 *
06 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
06/30/2016 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,
05/31/2016 Robert Cleland
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' h Av n n R f 4 1
06/15/2016 Robert Cleland
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
Ro ert C e an
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
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
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 l.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-'0:...:6:..!./-=3-=.0-'-/=.2.:..01=-6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 12 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183_60
15_30 183.60
15_30 183.60
15.30 183_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.
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 *
05 31 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
06/15/2016 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,
06/30/2016
05/31/2016
06 15 2016
·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
Fifth
Fifth
Fifth
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKIIND
DCOM
DOTH
DPTY
DSCC
IKIIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,O:..:6C!./-=3-=0!..../::.2::.0 1::.6=---__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page _-...::.13",--of 5 °
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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,ALSOENTER 1.0. NUMBER) CODE *
06 30 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
05/31/2016 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,
06/15/2016
06/30/2016
05 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
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
OSCC
Corporal
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 OS/22/2016
through __ ~0~6~/~3~0~/~2~01~6~ __ ___
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 14 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15,30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 *
06 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
06/30/2016 Ryan De Marta
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016 Angela Delnevo
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 R f
06/15/2016 Angela Delnevo
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
intermediary: 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
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
communications Dispatcher
City of San Rafael
communications Dispatcher
City of San Rafael
Commun1cat10ns D1spatc er
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _....::0;.:6"-./.::.3.:..0 /,-,2:..:0;.:1;.:6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 15 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 183.60
15.30 183.60
12 .00 144.00
12.00 144.00
12.00 144.00
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·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IFCOMMITIEE,ALSOENTER 1.0. NUMBER) CODE *
05/31/2016 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
06/15/2016 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,
06/30/2016
05/31/2016
·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
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 ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,0:...:6:.!./..:.3..:.0.!..../=.2.::.;01=-6=-__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 16 of 50
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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)
06 3D 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
05/31/2016 Scott Eberle
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 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,
1 2 Fifth Av n n f 4 01
06/30/2016 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
05 31 2016 Am~ Esparza
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
CODE *
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
rKJlND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Commun~cat~ons D~spatc er
City Of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ ~0~6~/~3~0~/~2~01~6~ __ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 17 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
12.00 132.00
FPPC Fonn 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 *
06 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
06/30/2016 Ami Esparza
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016
06/15/2016
·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
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Communications Dispatcher
City Of San Rafael
Communications Dispatcher
City Of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ ~0~6~/~3~0~/~2~01~6~ __ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 18 of 50
J.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 132.00
12.00 132.00
15.30 183.60
15.30 183.60
15.30 183.60
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 *
05/31 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
06/15/2016 Salvatore Garanzini
06/30/2016
05/31/2016
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
Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
M1C ae Garr1son
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
[RJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
DCOM
DOTH
DPTY
DSCC
[RJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
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 OS/22/2016
through _-,0:..:6C!./.=3..:.0.!.../=.2::.;0 1::.;6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page_----=-1=..9_ of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 *
06/30 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
05/31/2016 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,
06/15/2016 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 Fif h Av n n R 4
06/30/2016 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
05 31 2016 Justl.n Gra am
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
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Police Officer
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ o,-6--,/--,3_0-,-/_2_0_1_6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 20 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 I.D . NUMBER) CODE *
06/15/2016 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
06/30/2016 Justin Graham
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary : San Rafael Police Association,
05/31/2016 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 Fif h Av n
06/15/2016 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
06 30 2016 Lon. Hen n.C s
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94935
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
DeOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
Dsee
IR]IND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
OPTY
OSCC
Corporal
City of San Rafael
Corporal
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 OS/22/2016
through _-,0;.:6:..!./-=3..::0.!../=.2=-0 1=.:6=--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 21 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 183 .60
15 .30 183.60
12 .00 144.00
12 .00 144.00
12 .00 144 .00
66.60 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 *
05/31/2016 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
06/15/2016 Robert Henkle
06/30/2016
05/31/2016
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
Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
J. A exan er Ho m
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
Corporal
City of San Rafael
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through_-,0:...:6..!../.::.3",0/c..:2:..:O:...:1:..::6 __ _
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page 22 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
76.5°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 ,ALSO ENTER I.D . NUMBER) CODE *
06 30/2016 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
05/31/2016 Lisa Holton
06/15/2016
06/30/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ky e Hornste~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
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
Corpora
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,O:..:6:.!./..::3..::0!..../=-2.:..0 1=-6=--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 23 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
76.50 1
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 *
06 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
06/30/2016 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,
05/31/2016
06/15/2016
·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
IKJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
OPTY
OSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
OSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,,0:..:6.!../.=.3.::..0 /,-,2::..:0:..:1:..:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 24 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15_30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15_30 183.60
76.5°1
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·EMPLOYEO. ENTER NAME
OF BUSINESS)
(IF COMMITTEE . ALSO ENTER 1.0. NUMBER) CODE *
05/31/2016 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
06/15/2016 Scott Ingels
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
06/30/2016
05/31/2016
·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
[RJIND
DCOM
DOTH
DPTY
DSCC
[RJIND
DCOM
DOTH
DPTY
DSCC
[RJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
[RJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Records Clerk
City of San Rafael
Recor s
City of
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6--,/'-.3_0--,/_2_0_1_6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 25 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
12.00 144.00
12.00 144.00
69.90 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) CODE *
06/30/2016
05/31/2016
06/15/2016
06/30/2016
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
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
OCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IRJINO
DCOM
DOTH
OPTY
OSCC
IRJINO
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
OSCC
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
YSB Supervl.sor
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ ~0~6~/~3~0~/~2~01~6~ __ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page __ -=26=--of 50
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
12 .00 144.00
12.00 144.00
12.00 144.00
12 .00 144.00
60.001
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 *
06/15 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
06/30/2016 Rebecca Kuga
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016
06/15/2016
06 30 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
IKJIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
YSB Supervisor
City of San Rafael
YSB Supervisor
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 OS/22/2016
through __ 0_6..:../_3"",0/:....2_0_1_6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 27 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 144.00
12.00 144.00
15.30 183.60
15.30 183.60
15.30 183.60
69.90 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) CODE *
05 31/2016 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
06/15/2016 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,
06/30/2016 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,
o F' nu n R f 1 4 1
05/31/2016 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
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
IRJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
Dispatcher
City of San Rafael
Records Specialist
City of San Rafael
Recor s
City of
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,0:.::6..!.../.=.3.::..0 /<...:2:..:0:.::1:.::6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 28 of 50
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
12.00 144.00
12.00 144.00
12.00 144.00
12.00 144.00
60.001
FPPC Fonn 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 I,D, NUMBER) CODE *
06 30 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
05/31/2016 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,
06/15/2016 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,
1 2 Fi v e CA 4 1
06/30/2016 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
05 31 2016 Kev~n Mac ouga
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
Records SpeCialist
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,0,-6..:../..;;.3..;;.0-,-/_2 -,-0 1_6'--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_-=2=..9_ of 50
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
15.30 183.60
15.30 183 .60
15.30 183.60
15.30 183.60
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 I.D. NUMBER) CODE *
06 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
06/30/2016 Kevin Macdougald
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016 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 Fif h v n n R f I A
06/15/2016 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
Car os Ma ona 0
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
/!lIND
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 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _--=0:..:6,,-/.::.3.::..0,-,/2::..:0:..:1:..:6 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 30 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15 .30 183.60
15.30 183.60
15.30 183.60
76.5°1
FPPC Fonn 460 (Janl2016)
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)
05/31/2016 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
06/15/2016 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.
06/30/2016
05/31/2016
·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
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
OOIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
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 OS/22/2016
through _--=0:..:6"-/.::.3.::.0/""2:..:0:..:1:..:6'----__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 31 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183_60
15.30 183_60
15_30 183_60
12.00 144_00
12.00 144.00
FPPC Fonn 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)
06/30 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
05/31/2016 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,
06/15/2016
06/30/2016
·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 *
[RJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
OOIND
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
A m~n~strat~ve Tec ~c~an
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0'-'6'-'-/..o3..o0.!../_2..:..0 __ 16'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 32 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC . 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 144.00
15.30 183.60
15.30 183.60
15.30 183.60
12.00 144.00
69.90 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 COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE *
06/15/2016 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
06/30/2016 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,
05/31/2016
06/15/2016
06 30 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
IRIIND
DCOM
DOTH
DPTY
DSCC
!K]IND
DCOM
DOTH
DPTY
DSCC
!K]IND
DCOM
DOTH
DPTY
DSCC
IRIIND
DCOM
DOTH
DPTY
DSCC
Administrative Technician
City of San Rafael
Administrative Technician
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 OS/22/2016
through __ 0_6..:.../_3_0/=-2_0_1_6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 33 of 50
1.0. 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
12.00 144.00
12.00 144.00
12.00 144.00
12.00 144.00
60.001
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 *
05 31 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
06/15/2016 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,
06/30/2016
05/31/2016
·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
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Evidence Technician
City of San Rafael
Evidence Technician
City of San Rafael
Evidence Technician
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 OS/22/2016
through _--=0:..:6"-./.::.3.::..0/'-.:2:..:0:..:1:..:6 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 34 of 50
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
12.00 144.00
12.00 144.00
12.00 144.00
12.00 144.00
60.001
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 *
06/30/2016 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
05/31/2016 Leslie O'Toole
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
06/30/2016
05 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
OSCC
IKJIND
OCOM
OOTH
OPTY
OSCC
IRJIND
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 J.cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-,0:..:6C!./-=3..:.0:..../=.2.::.;0 1=.;6=---__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page_----=-3::..5_ of 50
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
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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)
06/15/2016 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
06/30/2016 Brian Patterson
05/31/2016
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
if h Av n e S 4 1
06/15/2016 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 SCC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
www.netfile.com
CODE *
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
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 OS/22/2016
through _--,0:..:6,-,-/..=3..=0-,-/.::.2.:..0 1=.:6=---__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 36 of 50
I,D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15 .30 183.60
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.
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 *
05/31/2016 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
06/15/2016 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,
06/30/2016 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 Fi h Av n n R fael CA 4
05/31/2016 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
06 15 2016 Aaron P~o 0
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
IK]IND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
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 ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0,-6....:./-'.3_0-,-/_2_0_16 __ _
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 37 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
IIF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
IIFCOMMITTEE.ALSOENTERI .D NUMBER) CODE *
06/30/2016 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
05/31/2016 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,
06/15/2016
06/30/2016
05 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
!!lIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
!!lIND
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
o ~cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/:2016
through _-,O:..:62../.=.3..:..0!.C/ 2::..:0:..:1:..:6'--__
SCHEDULE A (CaNT.)
CALIFORNIA 460
FORM
Page _-....::.3::..8 _ of 50
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
12.00 144 .00
12.00 144 .00
12 .00 144.00
15 .30 183 .60
FPPC Form 460 (Jan/201S)
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 *
06/15 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
06/30/2016 Dennis Prince
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016
06/15/2016
06 30 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
Police Association 1520 Fifth
94901
Police Association 1520 Fifth
Fifth
[KJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
DCOM
DOTH
DPTY
DSCC
[KJIND
DCOM
DOTH
OPTY
DSCC
[KJIND
DCOM
DOTH
OPTY
OSCC
[KJIND
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 OS/22/2016
through _--,0,-,6..!-/..:.3..:.0.:.../_2.;...0 1_6'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page_-=-3:!..9_ of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 *
05 31 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
06/15/2016 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,
06/30/2016
05/31/2016
06 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
IK]IND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
Corporal
City of San Rafael
Corporal
City of San Rafael
Corporal
City of San Rafael
Lead Communications
Dispatcher
City of San Rafael
Lea Commun1cat10ns
Dispatcher
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ ~0~6~/~3~0~/_2~01_6~ __ ___
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 40 of 50
1.0. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
12.00 144.00
12.00 144.00
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)
(IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) CODE *
06/30/2016 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
05/31/2016 Thomas Sabido
06/15/2016
06/30/2016
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
Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael, CA 94901
Ant ony Sca erC10
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
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
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 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6...:./_3_0-,-/_2_0_16 __ _
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 41 of 50
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
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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 *
06/15/2016 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
06/30/2016 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,
05/31/2016 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,
Fifth Av n 1 CA 4 01
06/15/2016 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
06 3D 2016 George Sc 1 ore
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 1cer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _-=0:..:6:.c/-=3-=0.!../;::..2.::.0 1.::.6=--__
SCHEDULE A (CONT.)
CALIFORNIA 460
FORM
Page 42 of 50
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183 .60
15 .30 183.60
15.30 183.60
15.30 183.60
15 .30 183.60
76.50 1
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (B66/275-3n2)
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·EMPLOYEO, ENTER NAME
OF BUSINESS)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
05/31/2016 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
06/15/2016 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,
06/30/2016 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,
2 F' Av n n R f 1 4 01
05/31/2016 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
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
!!lIND
DCOM
DOTH
DPTY
DSCC
IRJIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0,-,6..!./-,-3-,-0.!../_2-,-0 1_6'--__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 43 of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN . 1 -DEC , 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
15.30 183.60
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.
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 *
06/30/2016 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
05/31/2016 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,
06/15/2016
06/30/2016
·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
IR]IND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
IX]IND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
C~v~ ~an superv~sor
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through _--=0:..:6"-/.=3.=0:..../;::.2.:..01=-6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page _---=-44_=___ of 5 °
I.D.NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15 .30 183.60
15.30 183.60
15 .30 183.60
15.30 183.60
12 .00 144.00
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)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE *
06 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
06/30/2016 Charly Taylor
C/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael, CA 94901
Union member's dues received through
interm7diary: San Rafael Police Association,
05/31/2016 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,
2 Fif hAven eRA 4 1
06/15/2016 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
06 30 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
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
IKJIND
DCOM
DOTH
DPTY
DSCC
Civilian Supervisor
City of San Rafael
Civilian Supervisor
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 OS/22/2016
through _-'0:.:6"-/.::.3.::..0/'-'2:..:0:.:1:.:6'---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page 45 of 50
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
12.00 144.00
15.30 183.60
15.30 183.60
15.30 183.60
69.90 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 COMMITTEE, ALSO ENTER i.D. NUMBER) CODE *
05 31 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
06/15/2016 Michael Vergara
06/30/2016
c/o: San Rafael Police Association 1520 Fifth
Avenue
San Rafael. CA 94901
Union member's dues received through
intermediary: San Rafael Police Association.
Fifth
05/31/2016 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
06 15 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
DPTY
DSCC
!!lIND
DCOM
DOTH
DPTY
DSCC
!R]IND
DCOM
DOTH
DPTY
DSCC
!R]IND
DCOM
DOTH
DPTY
DSCC
IR]IND
DCOM
DOTH
DPTY
DSCC
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Sergeant
City of San Rafael
Dispatcher
City Of San Rafael
D~spatc er
City Of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/:2016
through _-,0:..:6C!./.:=.3.:=.0!.../::.2::.0 1::.;6=---__
SCHEDULE A (CO NT.)
CALIFORNIA 460
FORM
Page _---=.4 =-6 _ of 50
I.D. NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 183.60
15.30 183.60
15.30 183.60
12.00 132.00
12.00 132.00
69.90 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)
06/30/2016 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
05/31/2016 Mark Wilkinson
06/15/2016
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
Avenue
San Rafael, CA 94901
Union member's dues received through
intermediary; San Rafael Police Association,
1520 Fif v n R f 1
06/30/2016 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 94904
05 31 2016 Bl.anca Wl. mott
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
CODE *
IRJIND
DCOM
DOTH
DPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
IRJIND
OCOM
DOTH
OPTY
OSCC
Dispatcher
City Of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
Officer
City of San Rafael
SUBTOTAL $
Statement covers period
from OS/22/2016
through __ 0_6..:../_3_0:..../2_0_1_6 __ _
SCHEDULE A (CONT.)
I CALIFORNIA 460
FORM
Page 47 of 50
I.D . NUMBER
831553
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
12.00 132.00
15.30 183.60
15.30 183.60
15 .30 183.60
IS.30 168.30
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 *
06/15/2016 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
06/30/2016 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,
·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
DIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
DIND
DCOM
DOTH
DPTY
DSCC
Police Officer
City Of San Rafael
Police Officer
City Of San Rafael
SUBTOTAL $
SCHEDULE A (CONT.)
Statement covers period CALIFORNIA 460
FORM from OS/22/2016
through __ 0....;6..:../..;..3_0:..../2_0_1_6 __ _ Page 48 of 50
I.D.NUMBER
AMOUNT
RECEIVED THIS
PERIOD
831553
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
15.30 168.30
15.30 168.30
FPPC Form 460 (JanI2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
SCHEDULE E
ScheduleE
Payments Made Amounts may be rounded
to whole dollars.
Statement covers period
from OS/22/2016
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE th rough _..:.O..:.6!-/3::..c0::..!/..:.2:.:0..::1..:.6 __ Page _4_9_ of _5_0_
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.
0vP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTE contribution (explain nonmonetary)· OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating ill t.v. or cable airtime and production costs
FIL candidate filing/ballot fees A10 phone banks TRC candidate travel, lodging, and meals
FND fund raising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
III[) 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 ffif print ads VIlES information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Donor Stack, LLC WEB 99.27
5940 College Avenue, Suite F
Oakland, CA 94618
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 99.27
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ ____ ---'9'-'9--'._2_7
2. Unitemized payments made this period of under $1 00 .......................................................................................................................................... $ _____ --'0:....:.'-=0..::,0
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ ______ 0_._0_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 $ ____ --c9:.,:9;",: • ..:.2c.:.,7
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FPPC Form 460 (Jan/2016)
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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 I.D. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars.
Statement covers period
from OS/22/2016
through 06/30/2016
DESCRIPTION OF RECEIPT
SUBTOTAL $
1. Itemized increases to cash this period ........................................................................................................................ $ ____ ----'o,,-,.~o~o
2. Unitemized increases to cash of under $100 this period ............................................................................................. $ _____ 0::...:.c..:.7-=.1
3. Total of all interest received this period on loans made to others . (Schedule H, Column (e).) ................................. $ _____ 0::...:.'-"0..::.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:..,:. 7~1
SCHEDULE I
CALIFORNIA 460
FORM
Page __ 50_ of __ 50_
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