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Home My WebLink AboutForm 460 - Police Association PAC (2017-06-30)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from __ ---=.0=.1!..../ 0;::.1=.1'-'2::.:0::..;1=-7'--__ _ through _..::0..:::6.!.../.::.3.::.0/<...:2::.:0:..:1:..:7'--__ _ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. o Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure o State Candidate Election Committee Committee o Recall 0 Controlled (AisaCample/ePar15) 0 Sponsored (Alsa Camplele Par16) [19 General Purpose Committee ® Sponsored o Small Contributor Committee o Political Party/Central Committee 3. Committee Information o Primarily Formed Candidate/ Officeholder Committee (Also Camplele Par17) 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 JUL 25 2011 2. Type of Statement: o Preelection Statement 00 Semi-annual Statement o Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) Treasurer(s) NAME OF TREASURER Ms. Beth Minka MAILING ADDRESS 1520 Fifth Avenue CITY San Rafael NAME OF ASSISTANT TREASURER, IF ANY Ms. Stacy E. Owens MAILING ADDRESS 5940 College Avenue CITY Oakland OPTIONAL: FAX / E·MAIL ADDRESS STATE CA STATE CA of 198 Official Use Only o Quarterly Statement o Special Odd-Year Report o Supplemental Preelection Statement -Attach Form 495 ZIP CODE 94901 ZIP CODE 94618 AREA CODE/PHONE (415)485-3000 AREA CODE/PHONE (510)652-1000 I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correc\. n contained herein and in the attached schedules is true and complete . I certify Executed on 07/18/2017 Oate Executed on 07/18/2017 Oate Executed on Date Executed on Date www.netfile.com By __________ :;~~~~~~~~------------- By __________ ~~~~~~~~~~~~~~~~~~------------Signalure of Conlrclling Officeholder, candidale, Slale Measure Proponenl By ___________ ~~~~~~~~~~~~~~~~==~-------------Signature of Conlrclling OffICeholder, candidale, Slate Measure Proponenl 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 STREED CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D . NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 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 COVER PAGE -PART 2 _1IJI!lIIJI!II. 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 List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o 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. Line 3 $ 2 . Loans Rece ived .. ............. .... ................................... Schedule B. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 4 . Nonmonetary Contributions .................................... Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ Expenditures Made 6. Payments Made............ .................................. ......... Schedule E. Line 4 $ 7 . Loans Made ............................................................. Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bi"s) ............................... Schedule F. Line 3 10. Nonmonetary Adjustment .......................................... Schedule C. Line 3 11. TOTAL EXPENDITURES MADE ................................ AddLines8+9+ 10 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page. Line 16 $ 13. Cash Receipts ................................................... Column A. Line 3 above 14. Misce"aneous Increases to Cash ........................... Schedule I. Line 4 15. Cash Payments .................................................. Column A. Line 8 above 16 . ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14. then subtract Line 15 $ If this is a termination statement. Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ......... ......... ......... Schedule B. Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ www.netfile.com ColumnA TOTAL TH IS PERIOD (FROMATIACHED SCHEDULES) 14,727.50 0.00 14,727.50 0.00 14,727.50 2.169.04 0.00 2,169.04 0.00 0.00 2,169.04 57,238.63 14,727.50 3.04 2,169.04 69,800.13 0 .00 0.00 0 .00 from 01/01/2017 $ $ $ $ $ $ through ColumnB CALENDAR YEAR TOTAL TO DATE 14.727 .50 0.00 14,727 .50 0.00 14,727.50 2.169 .04 0 .00 2,169 .04 0 .00 0.00 2,169.04 To calculate Column S, add amounts in Column A to the corresponding amounts from Column S 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). 06/30/2017 Page _-=3,--_ of 198 I.D. NUMBER 831553 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20 . Contributions Received $ _____ _ $----- 21. Expenditures Made $ ____ _ $----- Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (If Subj ect to Voluntary ExpendHure lImltl Date of Election (mm/dd/yy) -----.1-----.1 __ Total to Date $----- $----- "Amounts in this section may be different from amounts reported in Column S. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF· EMPLOYED , ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSO ENTER I.D . NUMBER) CODE * 01/15/2017 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, 01/31/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 02/15/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association , 02/27/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael CA 94901 03 15 2017 El~sha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, Schedule A Summary 1 . Amount received this period -itemized monetary contributions. [!lIND DCOM DOTH DPTY OSCC OOINO DCOM DOTH DPTY DSCC [!lIND DCOM DOTH DPTY DSCC OOINO DCOM DOTH DPTY DSCC [!lIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Offl.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through 06/30/2017 SCHEDULE A CALIFORNIA 460 FORM Page _-,4!--_ of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 16 .30 16.30 16.30 16.30 81.50 1 195 .60 195.60 195.60 195.60 195.60 ·Contributor Codes INO -Individual (Include all Schedule A subtotals .) ........................................................................................................ $ ___ -=-14.=..!,c..:7..::.O=-2 :...:.1:.=..,0 COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) 2. Amount received this period -unitemized monetary contributions of less than $100 ............................. $ _____ ---'-25::....:...,.4=-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 $ ___ ---"'1."-4.:...., 7"'2=-7....; . ..::5-=-0 www.netfile.com PTY -Political Party . SCC -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER I.D . NUMBER) CODE * 03/31/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA .94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/14/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 04/30/2017 05/15/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6:..!/c..:3::.c0:.!/c..:2:..:0:..:1:....:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page_--=5_ of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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,ALSOENTERI.O.NUMBER) CODE * 06/15/2017 Elisha Adams C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/30/2017 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, 01/15/2017 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, 1 20 Fifth Aven e S n R fael A 4 1 01/31/2017 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 Rau AguJ. ar 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 [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _--,0:..:6:.!-/.;:.3.;:.0,-,/ 2::..:0:..:1:....:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page _--=-6_ of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.5°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·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 02/27/2017 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 03/15/2017 Raul Aguilar C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 03/31/2017 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, 1 2 Fif v n R f 1 CA 4 01 04/14/2017 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 Rau Agu~ ar 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 CODE * [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....:0:..:6-'./.::.3.::.0/'-.:2:..:0:.:1,--,7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page_-,-7_ of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195.60 16 .30 195 .60 16.30 195 .60 81. SO I 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) (IFCDMMITTEE.ALSOENTERI.D.NUMBER) CODE * 05/15/2017 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 05/31/2017 Raul Aguilar C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 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, 1 2 Fif h Av n e RICA 1 06/30/2017 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 Ant ony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contribulor Committee www.netfile.com [KJIND OCOM DOTH OPTY OSCC !!lIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC Sergeant 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 01/01/2017 through _-,0,-,6..:../.=.3..:..0/:...;2::..:0:..;:1,-,7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page_-=-8_ of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16 .30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.5°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·EMPLOY EO. ENTER NAME OF BUS INESS) (IF COMMITTEE . ALSO ENTER 1.0 . NUMBER) 01/31/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary : San Rafael Police Association . 1520 Fifth Avenue San Rafael CA 94901 02/15/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary: San Rafael Police Association. 02/27/2 017 Fifth 03/15/2017 Fifth 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 sce -Small Contributor Committee www.netfile.com CODE * IRIIND DeOM DOTH DPTY DSCC IRIIND DeOM DOTH DPTY Dsce IRIIND DCOM DOTH DPTY osee IRIIND DeOM DOTH DPTY DSCC IRIIND DeOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City o f San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page _-,,-9_ of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16 .30 195.60 16 .30 195 .60 16 .30 195.60 16.30 195.60 81. 50 I 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 * 04/14/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 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, 05/15/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Av nu an R f 1 A 4 1 05/31/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Ant ony 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, ·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 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 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 10 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 I.D . NUMBER) CODE * 06/30/2017 Anthony Augustyn C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary: San Rafael Police Association. 1520 Fifth Avenue San Rafael CA 94901 01/15/2017 James Bellamy 01/31/2017 02/15/2017 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 02 27 2017 James Be amy 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 IRJIND DCOM DOTH DPTY DSCC IRJIND DeOM DOTH DPTY osee IRJIND DCOM DOTH DPTY osee IRJIND DeOM DOTH DPTY Dsce IRJIND DCOM DOTH DPTY osee Officer City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....:0:..:6~/..::.3..::.0'-'/ 2::.;0:..:1:...:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 11 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 1 .30 195.60 81. 50 I 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) 03/15/2017 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 03/31/2017 James Bellamy 04/14/2017 04/30/2017 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 05 15 2017 James Be amy 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 -9., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page __ -=-12,,--of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16_30 195_60 16.30 195 _60 16_30 195_60 16_30 195 _60 8L501 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE . AlSO ENTER 1.0. NUMBER) 05/31/2017 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 06/15/2017 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, 06/30/2017 Fifth 01/15/2017 Fifth 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 * IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....::0:..::6-'../.::.3.::.;0/,-,2:..:0:..::1:..:.7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 13 of _...:1:..:9:..:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 81. 50 I 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) 02/15/2017 02/27/2017 03/15/2017 03/31/2017 (IF COMMITIEE. ALSO ENTER 1,0 . NUMBER) Kelly Benitez C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Kelly Benitez C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, Fifth Fifth 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 CODE * IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Off icer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 14 of 198 I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN, 1 -DEC, 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 B1.50 1 FPPC Form 460 (Jan/2016) 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) 04/30/2017 05/15/2017 05/31/2017 06/15/2017 (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) Kelly Benitez C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Kelly Benitez C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, Fifth Police Association 1520 Fifth 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 * [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC IKJIND DCOM DOTH DPTY DSCC OOIND OCOM DOTH OPTY OSCC OOIND DCOM DOTH OPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..6::..!/c...:3:..0::..!/c...:2:..:0:..:1:..:7 ___ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 15 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 B1.50 1 FPPC Form 460 (Jan/2016) 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 )F AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) 01/15/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/31/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 02/15/2017 02/27/2017 ·Conlributor Codes IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth CODE * IKJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6:..:/....:3:..:0:..:/....:2:.:0:.:1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 16 of 198 J.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16 .30 195.60 16.30 195.60 16.30 195 .60 16 .30 195 .60 81. 50 I 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 )Nhole 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) 03/31/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/14/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 04/30/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 F' Av n f 1 A 05/15/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Ra·fael, CA 94901 To Bern.nger 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 CODE * lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC lKJlND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _...:0c.::6.!..../.::..3 ",0/c..:2:..:0c.::1:..:.7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 17 of 19B I.D. NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16 .30 195 .60 16.30 195.60 16.30 195.60 B1.50 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) (IFCOMMIITEE. ALSO ENTER 1.0 NUMBER) CODE * 06/15/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/30/2017 Todd Berringer C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/15/2017 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 v R 1 A 4 01 01/31/2017 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 02 15 2017 Lynne Brac en 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 -Polilical Party SCC -Small Contributor Committee www.netfile.com [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Recor s City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6:..!/..:3:..:0,,-/..:2:.:0..:1:..:.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 18 of _...:1'-.:9:..::8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 12 .70 152.40 12.70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) 02/27/2017 03/15/2017 03/31/2017 (IF COMMITIEE. ALSO ENTER I D. NUMBER) 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 intermediary: San Rafael Police Association, Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 2 Fi h Av n San A 4 1 04/14/2017 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 04 30 2017 Lynne Brac en 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 CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Recor s City of SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 19 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12.70 152 .40 12.70 152.40 12.70 152.40 63.50 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 * 05/15/2017 05/31/2017 06/15/2017 06/30/2017 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 Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Rec ipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IKJIND OCOM DOTH OPTY OSCC !!lIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk Ci ty of San Rafael o l.cer City Of San Rafael SUBTOTAL $ Statement covers period fiom 01/01/2017 through _-,0:..:6",/,-,3:..:0,-,/...:2:..:0:..:1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 20 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152 .40 12.70 152 .40 12 .70 152.40 16 .30 130 .40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITTEE , ALSO ENTER 1.0 . NUMBER) CODE * 03/31/2017 Zachary Brickell 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 04/14/2017 Zachary Brickell C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 04/30/2017 Fifth 05/15/2017 Fifth 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 IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Officer City Of San Rafael Officer City Of San Rafael Officer City Of San Rafael Officer City Of San Rafael o ~cer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:...6::..:/,-,3:...0::..:/-=2:..:0;.:1:...7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 21 of _..::1.,:.9.:::.8 _ LD.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 130 .40 16 .30 130.40 16 .30 130 .40 16.30 130.40 16 .30 130 .40 81 .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·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE * 06/15/2017 Zachary Brickell 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 06/30/2017 Zachary Brickell C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 01/15/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fi h Av n 1 A 4 01 01/31/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 02 15 2017 Antonette Bu oc 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 IR]IND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND oeOM DOTH OPTY osee IKJIND oeOM DOTH OPTY osee IKJIND oeOM DOTH OPTY osee Officer City Of San Rafael Officer City Of San Rafael Community Service Officer 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 01/01/2017 through __ 0_6....:/_3_0-,-/_2_0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 22 of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 130.40 16.30 130.40 12.70 152 .40 12 .70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) IIFCOMMIITEE.ALSOENTERIO .NUMBER) CODE * 02/27/2017 03/15/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary: San Rafael Police Association. 1520 Fifth Avenue San Rafael CA 94901 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association. 03/31/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association. 1 2 Fift v 1 A 4 01 04/14/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary: San Rafael Police Association. 1520 Fifth Avenue. San Rafael. CA 94901 04 30 2017 Antonette Bu oc 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 [KjIND DCOM DOTH DPTY DSCC [KjIND DCOM DOTH DPTY DSCC IKlIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [KjIND DCOM DOTH DPTY DSCC Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Commun1ty Serv1ce 0 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ o_6:..:/-,3:....0;.:./...;.2-,0...;.1:....7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 23 of _....:1,,-,9,-,S,-- I.D.NUMBER S31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152 .40 12.70 152.40 12.70 152 .40 12 .70 152.40 12.70 152.40 63.50 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 BUSINESSI (IF COMMITIEE ,ALSO ENTER I D. NUMBER) 05/15/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/31/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, 20 Fifth Av u n R f el A 4 1 06/30/2017 Antonette Bullock C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Ml.c ae Byers C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * fR]IND DCOM DOTH DPTY DSCC fR]IND DCOM DOTH DPTY DSCC IX]IND DCOM DOTH DPTY DSCC fR]IND DCOM DOTH DPTY DSCC fR]IND DCOM DOTH DPTY DSCC Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0_6~/~3_0~/_2~0~1~7 ______ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 24 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12 .70 152 .40 12 .70 152 .40 16.30 114.10 67.10 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 IND)VIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTERI.D.NUMBER) CODE * 01/31/2017 Michael Byers C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/15/2017 Michael Byers C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/27/2017 Fifth 05/31/2017 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 Byers C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0"-6"'/'-'3:...0-'/_2-'0:..;:1:....7 ___ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 25 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 114.10 16_30 114 _10 16.30 114.10 16_30 114 _10 16 _30 114 .10 81_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) (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * 06/30/2017 01/15/2017 01/31/2017 02/15/2017 Michael Byers C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 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, Fifth Fifth Fifth ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dl.spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0"-6-'/;....3;....0-'/_2_0:....:1:....7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 26 of _..;:1:.,:9;.,;:8,-- I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 114 .10 12.70 152.40 12.70 152.40 12.70 152 .40 12.70 152 .40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSOENTERI.O.NUMBER) CODE * 03/15/2017 03/31/2017 04/14/2017 04/30/2017 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 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, Fifth Fifth Fifth ·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 OOIND oCOM DOTH OPTY OSCC OOIND oCOM DOTH oPTY OSCC OOIND oCOM DOTH oPTY OSCC [RJIND oCOM DOTH oPTY OSCC OOIND oCOM DOTH oPTY OSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dl.spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0,-,6:..!/-=3-=0,-,-/_2-=0..::1:...7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 27 of _-=1:..:9:..:8=-- 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12 .70 152.40 12 .70 152 .40 12.70 1 2.40 63 .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 COMMITIEE, ALSO ENTER LD. NUMBER) CODE * 05/31/2017 06/15/2017 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 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, 06/30/2017 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, 2 Fifth Aven 1 A 4 01 01/15/2017 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 01 31 2017 Josep Cam~ns 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 [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 28 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 16.30 195.60 16.30 195.60 70.70 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 * 02/15/2017 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 02/27/2017 Joseph Camins C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/15/2017 Fifth 03/31/2017 Fifth 04 14 2017 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 [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND 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 01/01/2017 through ___ 0~6~/~3~0~/_2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 29 of __ ....:1::..:9:...:8,-- 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 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 I,D, NUMBER) CODE * 04/30/2017 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 05/15/2017 Joseph Camins C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/31/2017 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 Fif v n n R f 1 A 4 1 06/15/2017 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 2017 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 seC) OTH -Other (e.g., business entity) PTY -Political Party sce -Small Contributor Committee www.netfile.com IRJIND DeoM DOTH DPTY osee IRJIND DeoM DOTH DPTY Dsce IKJIND DeoM DOTH DPTY osee IKJIND DCOM DOTH DPTY DSCC IRJIND DeoM DOTH DPTY Dsec 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 01/01/2017 through __ 0-,-6,-,/,-,3,-0;..:/_2_0_1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 30 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC, 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 B1. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTERI.D.NUMBER) CODE * 01/15/2017 01/31/2017 02/15/2017 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 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, Fifth 02/27/2017 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 03 15 2017 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, ·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 [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:.:6:..!/....:3:.:0",/-=2:..:0:..:1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 31 of _-=10..:9:..:8=-- 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 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) CODE * 03/31/2017 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 04/14/2017 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, 04/30/2017 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, 1 2 Fif h v n R f 1 A 4 01 05/15/2017 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 05 31 2017 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, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 32 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 1 .30 195.60 8l. 50 I 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) 06/15/2017 (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 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 06/30/2017 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, 01/15/2017 Fifth 01/31/2017 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 CODE * [KjIND DCOM DOTH DPTY DSCC [KjIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC !R]IND DCOM DOTH DPTY DSCC [KjIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police 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 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 33 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81. SO I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTERI.D.NUMBER) CODE * 02/27/2017 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 03/15/2017 Jack Carpenter C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 03/31/2017 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, 520 F' h Av n n R f 1 A 04/14/2017 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 intermediary: San Rafael Police Association, ·Contributor Codes IND-Individual 2' v 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 OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND DCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0_6~/~3_0~/_2~0~1_7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 34 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195 .60 81. 50 I 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 * 05/15/2017 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 05/31/2017 Jack Carpenter 06/15/2017 06/30/2017 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 Dav1 Casa nuovo 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 sec -Small Contributor Committee www.netfile.com IRJIND DCOM DOTH DPTY DSCC IRJIND DeOM DOTH DPTY osee IKJIND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY osee 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 01/01/2017 th rough __ 0_6-'/'-3'-0-'/_2_0_1_7 ___ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 35 of _..;1",9,-,:8:.-. 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195 .60 16 .30 195.60 16 .30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR )F AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF· EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 01/31/2017 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 02/15/2017 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, 02/27/2017 03/15/2017 ·Contributor Codes INO -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party sec -Small Contributor Committee www.netfile.com Fifth Fifth Fifth CODE * IRJIND DeOM DOTH DPTY Dsee IKJIND DeOM DOTH DPTY Dsee IK]INO DCOM DOTH DPTY Dsee IK]IND DCOM DOTH DPTY DSCC IRJINO DeOM DOTH DPTY Dsee 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 01/01/2017 through __ 0;....6:...:/....:3;....0,-,/-,-2;..:0_1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 36 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195 .60 16 .30 195.60 16.30 195.60 81. 50 I 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 I.D. NUMBER) CODE * 04/14/2017 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 04/30/2017 David Casalnuovo 05/15/2017 05/31/2017 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 Dav1 Casa nuovo 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 IKJIND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6:..:/..:3:..:0:..:/..:2:.:0:..:1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 37 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16.30 195.60 16.30 195 .60 16 .30 195 .60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR )F AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOVEO. ENTER NAME OF BUSINESS) IIF COMMITIEE , ALSO ENTER 1.0. NUMBER) CODE * 06/30/2017 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 01/15/2017 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. 01/31/2017 02/15/2017 ·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 OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6....:/_3_0...:./_2_0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 38 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195 .60 16 .30 195.60 16.30 195.60 81.50 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) 03/15/2017 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 03/31/2017 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, 04/14/2017 04/30/2017 ·Contributor Codes IND-/ndividual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfi/e.com Fifth Fifth Fifth CODE * IR]/ND DCOM DOTH DPTY DSCC IR]/ND DCOM DOTH DPTY DSCC IR]/ND DCOM DOTH DPTY DSCC IR]/ND DCOM DOTH DPTY DSCC IR]/ND 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 01/01/2017 through ___ 0~6~/~3~O~/_2_0_1_7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 3 9 of __ -,1",9::..:S,--- I.D.NUMBER S31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16_30 195.60 S1. 50 I 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·EMPLDYED. ENTER NAME OF BUSINESS) (IF CDMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 05/31/2017 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 06/15/2017 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, 06/30/2017 Fifth 01/15/2017 Fifth 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 IK]IND 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 l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ ~06~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 40 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195 .60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) IIF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * 02/15/2017 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 02/27/2017 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, 03/15/2017 Fifth 03/31/2017 Fifth 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 [RJIND DCOM DOTH DPTY DSCC IKlIND DCOM DOTH DPTY DSCC lRJlND DCOM DOTH DPTY DSCC lRJlND 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 01/01/2017 through __ 0::.:6",/,-,3::.:0,-,/,-,2:..:0:.:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 41 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195 .60 16.30 195.60 16.30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO , ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 04/30/2017 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 05/15/2017 Robert Cleland C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary : San Rafael Police Association. 05/31/2017 Fifth 06/15/2017 Fifth 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 [!JIND OCOM DOTH OPTY OSCC [!JIND OCOM DOTH OPTY OScc [!JIND OCOM DOTH OPTY OScc !!lIND oCOM DOTH oPTY OSCC [!JIND oCOM DOTH oPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6,,-,/c...:3::.c0:..!/c...:2:..:0:.:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 42 of _....:1",9",8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195 .60 16 .30 195.60 16.30 195.60 81. 50 I 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 * 01/15/2017 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 01/31/2017 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. 02/15/2017 02/27/2017 ·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 iK]IND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 43 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195 . 0 81. 50 I 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 BUSINESSl (IFCOMMITIEE .ALSOENTERI.D.NUMBERl CODE * 03/31/2017 Christopher Coale C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermedi ary : San Rafael Police Associ at i on, 1520 Fifth Avenue San Rafael CA 94901 04/14/2017 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, 04/30/2017 Christophe r Coale C/o: San Rafael Police Association 1520 Fifth 05/15/2017 ·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 94901 Fifth Fifth OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOINO DCOM DOTH DPTY DsCC OOIND DCOM DOTH DPTY DSCC OOINO DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant Ci ty of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 44 of __ -,1".,9,-,8,-- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATlVETO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO . ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER 1.0. NUMBER) 06/15/2017 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 06/30/2017 Christopher Coale 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 , 01/15/2017 Thomas Collins C/o: San Rafael Police Association 1520 Fifth 01/31/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 94901 Fifth Fifth CODE * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant 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 01/01/2017 through _-,0:..:6,,-,/-,3:..:0,-,/-,2:.:0:..:1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 45 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195 .60 16 .30 195.60 16 .30 195 .60 . 16.30 195 .60 8L501 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 IND)VIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER 1.0 . NUMBER) 02/27/2017 Thomas Collins C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 03/15/2017 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, 03/31/2017 04/14/2017 'Contributor Codes INO -Individual COM -ReCipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth CODE * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOINO DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..:6""'/'-'3:..:0'-'/-=2:..:0:..:1:..:7'----__ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 46 of _....:1'-.:9,-,S,--- I.D.NUMBER S31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195 .60 S1.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) 05/15/2017 Thomas Collins C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/31/2017 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, 06/15/2017 Fifth 06/30/2017 Fifth 01 15 2017 Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·Contributor Codes IND -Individual 2 . COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g .. business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Commun~cat~ons D~spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..::6-'../.::.3.::.0/,-,2:..:0:.:1:....:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 47 of _....:1'-.:9,-,S,-- I.D .NUMBER S31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195.60 16.30 195.60 12.70 152 .40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) 01/31/2017 Jenna Cotta c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/15/2017 Jenna Cotta 02/27/2017 03/15/2017 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, 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 03 31 2017 Jenna Cotta c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm~diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael Commun~cat~ons D~spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0;:...6::..;/c..:3:...O::..;/--=2:...0:.:1:...7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 48 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152 .40 12.70 152 .40 12 .70 152.40 12.70 152 .40 63.5°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 COMMITIEE , ALSO ENTER 1.0. NUMBER) CODE * 04/14/2017 Jenna Cotta c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 Jenna Cotta 05/15/2017 05/31/2017 c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 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 2017 Jenna Cotta c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·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 Communications Dispatcher City of San Rafael Communications Dispatcher 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 01/01/2017 th rough __ 0;:.6::.;/:..:3;:.0'-'/....:2:.:0:..:1:.:7 ___ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 4 9 of _-=1e..:9:..:8=--- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63_5°1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc_ca.gov (866/275-3772) wwwJppc.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 COMMmEE .ALSO ENTER 1.0. NUMBERI CODE * 06/30/2017 Jenna Cotta c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/15/2017 Deny Cruz C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/31/2017 Deny Cruz C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 20 Fif h Av u n R fa 1 A 4 1 02/15/2017 Deny Cruz 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 02 27 2017 Deny Cruz C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Communications Dispatcher City of San Rafael Communications Dispatcher 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 01/01/2017 through __ 0,-6;..:/,-3_0-,/....:2,-,0....:1=-7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 50 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12_70 152_40 12 .70 152.40 12.70 152.40 12.70 152 .40 63.5°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·EMPLOYEO, ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSOENTERI.O.NUMBER) CODE * 03/15/2017 Deny Cruz 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 03/31/2017 Deny Cruz C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 04/14/2017 Deny Cruz C/o: San Rafael Police Association 1520 Fifth 94901 04/30/2017 Deny Cruz 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 15 2017 Deny Cruz 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 Communications Dispatcher City Of San Rafael Communications Dispatcher City Of San Rafael Communications Dispatcher City Of San Rafael Communications Dispatcher City Of San Rafael Commun~cat~ons D~spatc er City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6::..!/c...:3::.c0:.!/..:2:..:0:..:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 51 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 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-EMPLOY EO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 05/31/2017 Deny Cruz 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 06/15/2017 Deny Cruz 06/30/2017 01/15/2017 01 31 2017 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 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 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 Communications Dispatcher City Of San Rafael Officer City of San Rafael o 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 52 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12 .70 152.40 16.30 195.60 16.30 195.60 70 .7°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) (IFCOMM 'TTEE ,ALSO ENTER '.0 . NUMBERI CODE * 02/15/2017 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 02/27/2017 Ryan De Marta 03/15/2017 03/31/2017 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 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 04 14 2017 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, ·Contributor Codes IND -Individual 2 ' COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party sec -Small Contributor Committee www.netfile.com [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY Dsec [RJIND DCOM DOTH DpTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY osee 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 01/01/2017 th rough __ 0=-6"'/'-'3=-0:..:/-=2:..:0:..:1:..:7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 53 of _.;::1c.:.9.=.8_ 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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 * 04/30/2017 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 05/15/2017 Ryan De Marta 05/31/2017 C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm~diary: San Rafael Police Association, Fifth 06/15/2017 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 2017 Ryan De Marta C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm~diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer Ci t y of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 54 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16 .30 195 .60 16 .30 195 .60 16.30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITIEE.ALSOENTERI.O.NUMBER) CODE * 01/15/2017 01/31/2017 02/15/2017 02/27/2017 Blake Delzell 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 Blake Delzell 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 IRJIND OCOM DOTH OPTY oscc IRJIND OCOM DOTH OPTY osce IRJIND oeOM DOTH OPTY oscc IRJIND oeOM DOTH OPTY osce IRJIND oeoM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 55 of __ ...;1o..:9:..:8=-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 _60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195 .60 8L501 FPPC Form 460 (Jan/2016) FPpe 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) 03/31/2017 04/14/2017 04/30/2017 05/15/2017 (IF COMMITTEE . ALSO ENTER 1.0 NUMBER) Blake Delzell 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 Blake Delzell 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 Fifth Fifth ·Contributor Codes IN 0 -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 * OOIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DpTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 56 of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195 .60 16 .30 195 .60 16.30 195.60 16 .30 195.60 81. 50 I 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) 06/15/2017 06/30/2017 01/15/2017 01/31/2017 (IF COMMITTEE , ALSO ENTER 1.0. NUMBER) Blake Delzell 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 Blake Delzell 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 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 C rl.stl.an Dl.az 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 CODE * IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0=-6:..!/c...:3=-0,-,/c...:2:..;0:..;:1=-7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 57 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE * 02/27/2017 03/15/2017 03/31/2017 04/14/2017 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 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, 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 C r~st~an D~az C/o : San Rafael Pol i ce 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 IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal Ci ty of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 58 of _....:1:..:9:..:8,,- 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16.30 195 .60 16.30 195.60 16 .30 195.60 81. 50 I 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 liP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) 05/15/2017 05/31/2017 (IF COMMITTEE. ALSO ENTER 1.0. NUMBERI 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 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, 06/15/2017 Christian Diaz C/o: San Rafael Police Association 1520 Fifth 06/30/2017 ·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 94901 Fifth Fifth CODE * !K]IND OCOM DOTH OPTY OSCC !K]IND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC !K]INO OCOM DOTH OPTY OSCC !K]INO OCOM DOTH OPTY OSCC Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ O:..:6",/c...:3:..:0:.!/c...:2:.:0:.:1:..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 59 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 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 CDMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 01/31/2017 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 02/15/2017 Christopher Duncan C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/27/2017 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 Fi Av n n R fa 1 A 4 01 03/15/2017 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 C r~stop er Duncan C/o: San Rafael Police Association 1520 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 94901 IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC !RlIND 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 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 60 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 16 .30 195.60 B1. 50 I 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) 04/14/2017 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 04/30/2017 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, 05/15/2017 05/31/2017 ·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 OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period I from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 61 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16 .30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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) 06/30/2017 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 01/15/2017 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, 01/31/2017 02/15/2017 02 27 2017 '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 OCOM DOTH OPTY OSCC !RJIND OCOM DOTH OPTY OSCC !RJIND OCOM DOTH OPTY OSCC ·!RJIND OCOM DOTH OPTY OSCC !RJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0:....6:...:/-,3,-0,-,-/-,2,-,0..=1:....7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 62 of _--,1".,9:.:8'-.- 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195.60 81.50 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 * 03/15/2017 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 03/31/2017 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, 04/14/2017 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, 152 Fif h Av n a 1 CA 4 01 04/30/2017 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 15 2017 Scott E er e 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.9., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page __ -.::.63=--of 19 B I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195,60 81.50 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 * 05/31/2017 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 06/15/2017 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, 06/30/2017 Fifth 01/15/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 01 31 2017 Kev~n F~nerty 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 INO -Individual . v 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 IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6:..!/-=3:..c0,-,/-=2:..:0:..:1:....:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 64 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 * 02/15/2017 02/27/2017 Kevin Finerty 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 Kevin Finerty C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/15/2017 Kevin Finerty C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 20 Fif h v San A 4 03/31/2017 Kevin Finerty 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 04 14 2017 Kevln Flnerty 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 OOINO DCOM DOTH DPTY DSCC OOINO DCOM DOTH DpTY DSCC OOINO DCOM DOTH DpTY DSCC OOINO DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 65 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195 .60 81. 50 I 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, EI'lTER NAME OF BUSINESS) (IF COMMmEE, ALSO EI'lTER 1.0, NUMBER) CODE * 04/30/2017 05/15/2017 Kevin Finerty 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 Kevin Finerty C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 05/31/2017 Kevin Finerty C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 20 Fifth Av nu n R f 1 4 1 06/15/2017 Kevin Finerty 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 2017 Kev~n F~nerty 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 Comm ittee (other than PTY or SCC) OTH -Other (e .g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6",/c...:3::.c0,-,/c...:2:.:0:..:1:.:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 66 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC , 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195 .60 16 .30 195.60 16 .30 195.60 81.50 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 * 01/15/2017 01/31/2017 02/15/2017 02/27/2017 03 15 2017 Scott Fisher C/o: San Rafael Police Association 1520 Fifth Avenue San Rafae l , CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Scott Fisher 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 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 IR]IND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DpTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Po lice Officer City Of San Rafael Pol i ce Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0,-,6,-,/-,3-,0,-,-/_2;..:0-=1=--7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 67 of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195 .60 16.30 195 .60 16.30 195 .60 16 .30 195 .60 81. 50 I 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) 03/31/2017 04/14/2017 (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) Scott Fisher 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 Scott Fisher C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 04/30/2017 Scott Fisher 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 F' Aven 1 CA 4 01 05/15/2017 Scott Fisher 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 2017 Scott Fl.S er 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 CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 68 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 16 .30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER I.D. NUMBER) CODE * 06/15/2017 06/30/2017 Scott Fisher 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 Scott Fisher C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 01/15/2017 Anna Fulgado 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 v n S n R fael A 4 01 01/31/2017 Anna Fulgado 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 02 15 2017 Anna Fu ga 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 OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dl.spatc er City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0,-,6:...:/-=3,-,0:..:./-=2:..;:0..=1,-,7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 69 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 12 .70 152.40 12 .70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE.ALSOENTERLD .NUMBERI CODE * 02/27/2017 Anna Fulgado 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 03/15/2017 Anna Fulgado C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/31/2017 Fifth 04/14/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 04 30 2017 Anna Fu ga 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 [RJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dl.spatc er City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 I through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 70 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 l FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTER 1.0. NUMBER) CODE * 05/15/2017 05/31/2017 06/15/2017 06/30/2017 Anna Fulgado 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 Anna Fulgado 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 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 osee IKJIND DeOM DOTH DPTY osee IKJIND DeOM DOTH DPTY osee IKJIND DeOM DOTH DPTY osee IKJIND DeOM DOTH DPTY osee Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dispatcher City Of San Rafael Dispatcher City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:....6:...:/...::3:....0:...:/-=2:....0...::1:....7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 71 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12.70 152.40 12 .70 152.40 16.30 195 .60 FPPC Form 460 (Jan/2016) 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 * 01/31/2017 02/15/2017 02/27/2 017 03/15/2017 Christopher Fuller C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Christopher Fuller 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 Ihan PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND DCOM DOTH OPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6:..!/....:3:..:0,-,,/....:2:..:0:..:1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 72 of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16 .30 195 .60 16.30 195 .60 16 .30 195 .60 B1. 50 I 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) 04/14/2017 04/30/2017 05/15/2017 (IF COMMITTEE, ALSO ENTER I D. NUMBER) Christopher Fuller C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Christopher Fuller C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 20 Fifth Aven R f 1 A 4 05/31/2017 Christopher Fuller C/o: San Rafael Police Association 1520 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 94901 Fifth CODE * IK]IND OCOM DOTH OPTY OSCC !!lIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 73 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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) 06/30/2017 01/15/2017 (IF COMMllTEE. ALSO ENTER 1.0 . NUMBER) Christopher Fuller C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Salvatore Garanzini C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/31/2017 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, 1 20 Fif h v fa 1 A 4 02/15/2017 Salvatore Garanzini C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Sa vat ore Garanz~n~ 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 IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6...:./_3_0..:../_2_0_17 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 74 of _...;:1",,9:..:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 81. SO I 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) 03/15/2017 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 03/31/2017 Salvatore Garanzini C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 04/14/2017 Fifth 04/30/2017 Fifth 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 sce -Small Contributor Committee www.netfile.com CODE * [KJIND DCOM DOTH DPTY Dsce [KJIND DeOM DOTH DPTY Dsec [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DeOM DOTH DPTY Dsce 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 01/01/2017 through __ 0,-,6",/-=3,-,0",/-=2:...:0",1,-,7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 75 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16 .30 195.60 16.30 195 .60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER IIF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 05/31/2017 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 06/15/2017 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, 06/30/2017 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 Fif h Av n fa 1 CA 4 01/15/2017 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 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 IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC Officer City of San Rafael 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 01/01/2017 through __ 0::.;6:..!/-=3:...::0,,-/-=2..:.0.:::1.:...7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 76 of _-=1:..:9:..:8=-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195 .60 16 .30 195 .60 16.30 195.60 81.5°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 COMMIITEE, ALSO ENTER 1.0. NUMBER) 02/15/2017 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 02/27/2017 Michael Garrison C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/15/2017 Fifth 03/31/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 M~c ae Garr~son C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, ·Contributor Codes IND-Individual 2 . COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IKJIND oCOM DOTH oPTY OSCC !K]IND oCOM DOTH oPTY OSCC IKJIND oCOM DOTH oPTY OSCC IKJIND oCOM DOTH DPTY OSCC IKJIND oCOM DOTH oPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..:6,-,/-=3:..:0,-,/-=2:.:0:..:1:....:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 77 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVETO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195.60 16.30 195 .60 16 .30 195 .60 81. 50 I 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 * 04/30/2017 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 05/15/2017 Michael Garrison 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, 05/31/2017 Fifth 06/15/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 M~c ae Garr~son C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm~diary: San Rafael Police Association, ·CDntributDr Codes IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:.:6:.!/-=3:.:0",/-=2:.:0-=1,-,7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 78 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 * 01/15/2017 01/31/2017 02/15/2017 02/27/2017 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 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, Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 L~ a Gav ~c C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through 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 IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0",6:..:/...:3,-,0:..:./...:2:..;:0...:1,-,7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 79 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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) 03/31/2017 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 04/14/2017 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, 04/30/2017 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 hAven e S n R f el A 4 01 05/15/2017 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 LJ. a Gav J.C 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 CODE * IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH DPTY OSCC IR]IND DCOM DOTH DPTY OSCC IR]IND OCOM DOTH OPTY OSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page __ --"-B=..O_ of 19B I.D. NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 B1. 50 I 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) 06/15/2017 06/30/2017 01/15/2017 01/31/2017 02 15 2017 (IF COMMITIEE, ALSO ENTER I O. NUMBER) Lilah Gavlick C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 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, ·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 * IRJJND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee IRJIND DeoM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee Police Officer City of San Rafael Police Officer City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....:0:..::6"-/~3~0 /,-,2::..:0:..::1:..:7 __ _ SCHEDULE A (eONT.) CALIFORNIA 460 FORM Page 81 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC , 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16_30 195.60 16_30 195.60 16_30 195 .60 16.30 195.60 81.50 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) 02/27/2017 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 03/15/2017 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, 03/31/2017 Justin Graham C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 2 Fif h Av n n R f el A 4 01 04/14/2017 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 04 30 2017 Just~n Gra am 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 CODE * IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0:...:6:..:/-=3=-0,--,/-=2:...:0",1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 82 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.goy (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITTEE ,ALSO ENTER 1.0. NUMBER) CODE * 05/15/2017 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 05/31/2017 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, 06/15/2017 Justin Graham C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 20 Fif hAven e A 4 06/30/2017 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 01 15 2017 Lor~ Hen r~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 IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Dl.spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:...:6.!../.=.3.=.0 /,-,2::..:0:.:1,-,7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 83 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMliTEE, ALSO ENTER 1.0. NUMBER) 01/31/2017 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 02/15/2017 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. 02/27/2017 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. 20 Fif hAven S n f el A 4 1 03/15/2017 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 03 31 2017 Lor~ Hen r~c s C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94935 Union member's dues received through interm~diary: San Rafael Police Association. ·Conlributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IKIIND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC lRJlND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael D~spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _...:0...:6.!-/.=.3.=.0 /,-,2::..:0...:1:...:.7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 84 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63 .5°1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE.ALSOENTERLD.NUMBER) CODE * 04/14/2017 04/30/2017 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 Lori Hendricks C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94935 Union member's dues received through interm7diary : San Rafael Police Association, 05/15/2017 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, 20 Fifth Aven n R f el A 05/31/2017 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 15 2017 Lor1 Hen r1C 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 f&]IND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC fR]/ND OCOM DOTH OPTY OSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael D1spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _--=O:..=6..!../.=.3.::.0 /:....:2::..:0:..:1:....:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 85 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152 .40 12.70 152 .40 12.70 152.40 12.70 152.40 63.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER 1.0. NUMBERI CODE * 06/30/2017 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 01/15/2017 Robert Henkle C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 01/31/2017 Fifth 02/15/2017 Fifth 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 IKJIND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DpTY DSCC IR]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Dispatcher City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _--=O:..:6C!../.::.3.::.0 /~2::.:0:..:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 86 of _....::1'-.:9:..::8=--- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULAT)VE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 16.30 195 .60 16.30 195 .60 16.30 195 .60 16.30 195.60 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·EMPLOYEO, ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTERI.O.NUMBER) CODE * 03/15/2017 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 03/31/2017 Robert Henkle 04/14/2017 04/30/2017 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 Ro ert Hen e 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 . ·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 IR]IND DCOM DOTH DPTY Dsec 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 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 87 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 81. 50 I 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 * 05/31/2017 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 06/15/2017 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, 06/30/2017 01/15/2017 'Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0=-6::..!/'-'3:....0:..:/-=2:....0:..:1:....7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 88 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 1,0 , NUMBER) CODE * 02/15/2017 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 02/27/2017 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, 03/15/2017 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, 1 20 Fifth Avenue San Rafael A 4 01 03/31/2017 J. Alexander Holm C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·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 Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:...:6C!../.::.3.::.0,-,/2::.c0:...:1:....:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page _-=-89=-...... of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER 1.0 . NUMBER) 04/30/2017 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 05/15/2017 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, 05/31/2017 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, 1 20 Fif h v n e San R f 1 A 4 1 06/15/2017 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 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 INO -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 CODE * IK]INO DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]INO DCOM DOTH DPTY DSCC IK]INO DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:....:6:..!./-=3....:0-,-/.=2..:.0=.1 7-'--__ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 90 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195 .60 16 .30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) 01/15/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/31/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/15/2017 02/27/2017 03 15 2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6:..!/c..:3::.c0:.!/c..:2:.:0:..:1:...;7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 91 of _-,1::..:9:..:8==---- 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16 .30 195.60 16 .30 195 .60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMlnEE. ALSO ENTER I.D. NUMBER) CODE * 03/31/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/14/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 04/30/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 20 Fif n R f 1 A 4 01 05/15/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 05 31 2017 L~sa Ho ton 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 [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6-,/,-3_0....:/_2_o_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 92 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 81.50 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 * 06/15/2017 Lisa Holton C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/30/2017 Lisa Holton C/o: S'an Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/15/2017 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 F' Av n n R f 1 A 01/31/2017 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 Ky e Hornstel.n 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 !RlIND DCOM DOTH DPTY DSCC !RlIND DCOM DOTH DPTY DSCC !RlIND DCOM DOTH DPTY Dsee !RlIND DeOM DOTH DPTY Dsee !RlIND DeOM DOTH DPTY Dsee Sergeant City of San Rafael Sergeant City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0"-6"'/'-'3:....0:...:/-=2:....0-=1:....7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page_-=-93=--of 198 tD.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195 .60 16.30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 02/27/2017 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 03/15/2017 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, 03/31/2017 Fifth 04/14/2017 Fifth 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 CODE * IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC !RlIND DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6:...:/....:3;...0:..:./...:2=-0...:1;...7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 94 Of _--=l,,",9,-!S,--- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16 .30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 05/15/2017 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 05/31/2017 Kyle Hornstein 06/15/2017 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, 1 20 Fifth Av n A 4 1 06/30/2017 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 Car H er C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Conlributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Polilical Party SCC -Small Contributor Committee www.netfile.com CODE * IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _..:0c.::6.!../.::..3 -",0 /c..:2:..:0c.::1:..:.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 95 of 198 i.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 81. 50 I 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) 01/31/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/15/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/27/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 20 Fifth Avenue S n R fa 1 CA 4 01 03/15/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Car Hu er 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 2 . COM -Recipient Committee (other than PTY or seC) OTH -Other (e.g .• business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IK]IND DCOM DOTH DPTY DSCC !!lIND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0",6:..:/-=3",0",/-=2:..;:0-=1,-,7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 96 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0, NUMBER) 04/14/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/15/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 F' h Av n f 1 A 4 01 05/31/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Car H er C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through 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 sec -Small Contributor Committee www.netfile.com CODE * IRJIND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee !K]IND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee IRJIND DeOM DOTH DPTY osee Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6,-,/ __ 3 __ 0-,/_2_0_1_7 __ _ SCHEDULE A (eONT.) CALIFORNIA 460 FORM Page 97 of_-=1.::.9-".8_ I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195 .60 81. 50 I FPPC Form 460 (Jan/20i6) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE . ALSO ENTER 1.0 . NUMBER) 06/30/2017 Carl Huber C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/15/2017 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, 01/31/2017 02/15/2017 02 27 2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g .• business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth CODE * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC /R)IND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6:;.!/c..:3::...:O,-,/--=2::...:0:..:1::...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 98 of _....:1:..:9::..:8,-- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16.30 195 .60 16.30 195 .60 16.30 195.60 81. 50 I 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 O. NUMBER) 03/15/2017 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 03/31/2017 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, 04/14/2017 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, 1 20 Fif v n R fa 1 CA 4 1 04/30/2017 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 05 15 2017 Scott Inge s 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.netfi/e.com CODE * IR]IND oCOM DOTH oPTY OSCC IR]IND oCOM DOTH oPTY oscc IR]IND oCOM DOTH oPTY OSCC IR]IND oCOM DOTH oPTY OSCC IR]IND oCOM DOTH oPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....::O...:6.!..../..:..3 -,-,0/c..:2::..:O:...::1:..c.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 99 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 81. 50 I 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 * 05/31/2017 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 06/15/2017 Scott Ingels 06/30/2017 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, 1 20 Fifth Av n e A 4 01/15/2017 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 Re ecca 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, ·Contributor Codes IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY oscc OOIND OCOM DOTH OPTY oscc OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Records Clerk City of San Rafael Recor s City of SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0_6,-,/,-,3,-0;..:/-=2:...;0",1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 100 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195 .60 12 .70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) 02/15/2017 02/27/2017 IIF COMMITTEE. ALSO ENTER 1.0 . NUMBER) 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 Rebecca Jensen c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/15/2017 Rebecca Jensen c/o San Rafael Police Association 1520 Fifth 94901 03/31/2017 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 Re ecca 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, ·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 * IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Recor s City of SUBTOTAL $ Statement covers period from 01/01/2017 through _...:0..=6.!..../=..3 0,,-,/c...:2:..:O:..::1:...:.7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 101 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12 .70 152.40 12 .70 152 .40 12 .70 152 .40 12 .70 152 .40 63.50 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) 04/30/2017 05/15/2017 (IF COMMITIEE. ALSO ENTER to. NUMBER) 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 Rebecca Jensen c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/31/2017 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, 20 Fifth Aven e S n A 4 01 06/15/2017 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 Re ecca Jensen c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g .• business entity) PTY -Political Party SCC -Small Conlributor Committee www.netfile.com CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND DCOM DOTH DPTY oscc IKJIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Records Clerk City of San Rafael Recor s City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0.;..6'-'/'-3:...0;..:/_2_0_1_7 ___ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 102 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12 .70 152.40 12.70 152.40 12.70 152.40 63.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER 1.0 . NUMBER) 01/15/2017 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 01/31/2017 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, 02/15/2017 Fifth 02/27/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Re ecca 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, ·Contributor Codes IND -Individual 2 . 4 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 * IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB supervl.sor City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....:0:...::6.!-/.::.3",0 /,-,2:..:0:..::1:..:.7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 103 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12 .70 152.40 12.70 152.40 12.70 152.40 63.50 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 I D. NUMBER) CODE * 03/31/2017 04/14/2017 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 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, 04/30/2017 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 v n R f 1 A 4 01 05/15/2017 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 Re ecca 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, 'ContributDr Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB Supervisor City of San Rafael YSB Supervl.sor City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/_2~0_17 ______ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 104 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63 .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 * 06/15/2017 06/30/2017 01/15/2017 01/31/2017 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 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, Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 02 15 2017 Marc Lap ante 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 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 IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC 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 01/01/2017 through __ 0:...6:..!/c...:3:...0,-,/c...:2:..:0:..:1:...7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 105 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152.40 12 .70 152.40 16 .30 195 .60 16.30 195.60 16.30 195.60 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, EmER NAME OF BUSINESS) (IF COMMITIEE, ALSO EmER 1.0. NUMBER) 02/27/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 03/15/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 03/31/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, 1520 Fift v R fa 1 A 4 01 04/14/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 04 30 2017 Marc Lap ante 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 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 01/01/2017 through _....:0:...:6C!../.::.3.::.0,-,/ 2::.:0:..:1:....:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 106 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 81. 50 I 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·EMPLDYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE .ALSOENTER 1.0. NUMBER) CODE * 05/15/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/31/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 15 0 Fif hAven 1 CA 4 06/30/2017 Marc Laplante C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Ann ora 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, ·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 [KJIND OCOM DOTH OPTY oscc [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY oscc [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael D1spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6,-,/-,3-,0-,-/_2_0_1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 107 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195.60 16.30 195.60 12 . 0 152.40 77 .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-EMPLDYED, ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * 01/31/2017 02/15/2017 02/27/2017 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 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, Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fif h Av R f 1 A 4 1 03/15/2017 Anndora Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Ann ora Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·ContributDr Codes IND -Individual 2 F' A 4 COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -PDlitical Party SCC -Small CDntributor Committee www.netfile.com IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael D1spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::...:6,,-,/...:3...:0-,-/-=2..:.0.::.1.:...7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 108 of _-=1:..:9:..:8=-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 AO 12.70 152.40 12.70 152.40 12.70 152AO 12_70 152 AD 63_50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) 04/14/2017 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 04/30/2017 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, 05/15/2017 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, 1 20 Fifth Ave A 4 1 05/31/2017 Anndora Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue , San Rafael, CA 94901 Ann ora Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member 's dues received through interm7diary: San Rafael Police Associat i on, ·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 * /KlIND DCOM DOTH DPTY DSCC /KlIND DCOM DOTH DPTY DSCC /KlIND DCOM DOTH DPTY DSCC /KlIND DCOM DOTH DPTY DSCC /KlIND DCOM DOTH DPTY DSCC Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael Dispatcher City of San Rafael D1spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ __ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 109 of 19B I.D . NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12 .70 152.40 12 .70 152 .40 12.70 152 .40 12 .70 152.40 63 .50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) 06/30/2017 01/15/2017 01/31/2017 02/15/2017 (IF COMMITTEE. ALSO ENTER I,D. NUMBER) Anndora Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Judy Lee C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: 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 CODE * [RJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IXJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Dispatcher City of San Rafael Records Specialist City of San Rafael Records Specialist City of San Rafael Records Specialist City of San Rafael Recor s City of SUBTOTAL $ Statement covers period from 01/01/2017 through _-,O:..:6:..!/....:3:..:0",/....:2:..:0c::1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 110 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC , 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152 .40 12.70 152.40 12.70 152.40 12.70 152 .40 12 .70 152.40 63 .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,ALSOENTERI.O.NUMBER) CODE * 03/15/2017 03/31/2017 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 Judy Lee C/o; San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary; San Rafael Police Association , 04/14/2017 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, 1 20 Fif h Av R f 1 A 4 01 04/30/2017 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 intermediary ; San Rafael Police Associat i on, ·Conlributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contribulor 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 Records Specialist City of San Rafael Records Specialist City of San Rafael Records Specialist City of San Rafael Records Specialist City of San Rafael Recor s City of SUBTOTAL $ Statement covers period from 01/01/2017 through __ O:..:6::.!/..:3..:0,,-/..=2..:.0..=1.:..7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page _-=.11::;1::... of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12 .70 152.40 12.70 152.40 63 .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) (IFCDMMITIEE,ALSO ENTER I.D. NUMBER) CODE * 05/31/2017 06/15/2017 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 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, 06/30/2017 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, 1 20 Fifth Av n R f 1 A 4 01/15/2017 Rogelio Leon C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Roge l.0 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, ·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 IKIIND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH DPTY DSCC IKIIND DCOM DOTH OPTY OSCC IKIIND DCOM DOTH DPTY DSCC Records Specialist City of San Rafael Records Specialist City of San Rafael Records Specialist City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..6:.!/c.:3::..:O:.!/..:2::..:0:.:1::..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 112 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152 .40 12 .70 152.40 12 .70 152.40 16.30 179.30 16 .30 179.30 70.70 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 * 02/15/2017 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 02/27/2017 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, 03/15/2017 03/31/2017 ·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 IR]IND DCOM DOTH DPTY DSCC IR]IND DCOM DOTH DPTY DSCC IR]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 Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _...:0...:6.!../.::..3 -,-,0/'-.:2::.:0:.::1:.c.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 113 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 179.30 16 .30 179.30 16 .30 179 .30 16.30 179.30 16 .30 179 .30 81. 50 I 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) IIF COMMITTEE . ALSO ENTER 1.0 . NUMBER) 04/30/2017 Rogelio Leon C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received thro~gh intermediary : San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/15/2017 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, 05/31/2017 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, 20 Fifth Av ue A 4 01 06/15/2017 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 01 15 2017 Kev~n Mac ouga 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 2 . COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Polilical Party SCC -Small Conlribulor Committee www.netfile.com CODE * IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY oscc IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Sergeant 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 01/01/2017 through ___ 0~6~/~3~O~/~2~O~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page __ --=.1l=..4=_ of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 179.30 16 .30 179.30 16.30 179 .30 16.30 179 .30 16.30 195 .60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * 01/31/2017 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 02/15/2017 Kevin Macdougald 02/27/2017 03/15/2017 03 31 2017 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, ·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 IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY OSCC IK]IND 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 01/01/2017 through __ 0:.:6:.!/-=3:...:0,-,/-=2:.:0:.:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 115 of _...:1",,9:.:8,-- I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE,ALSO ENTER 1.0. NUMBER) CODE * 04/14/2017 Kevin Macdougald C/o: San Rafael Police Association 1 520 Fifth Avenue San Rafael, CA 9 4 901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 Kevin Macdougald 05/15/2017 05/31/2017 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 06 15 2017 Kev~n Mac ouga C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues r e ceived through intermediary : San Rafael Police Associat i on, ·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 IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6...:./_3_0..:../_2_0_1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page _--=.11::6"-. of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16 .30 195.60 16 .30 195 .60 16 .30 195 .60 16 .30 195 .60 81 .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 BUS IN ESS) (IF COMMITTEE. ALSO ENTER 1.0 . NUMBER) CODE * 06/30/2017 Kevin Macdougald C/o : San Rafael Pol i ce Association 1520 Fifth Avenue San Rafael, CA 94901 Union membe r 's dues received through intermediary : San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/15/2017 Carlos Maldonado C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 01/31/2017 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 , 1 20 Fifth v n R f el CA 4 01 02/15/2017 Carlos Maldonado 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 [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..6:..:/-=3:..0:..!/-=2:...:0c::1:..7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 11 7 of _-=1..::.9.::.8_ I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16 .30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 * 03/15/2017 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 03/31/2017 Carlos Maldonado C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association. 04/14/2017 Fifth 04/30/2017 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 IK)IND OCOM DOTH OPTY OSCC IK)IND OCOM DOTH OPTY OSCC lKJlND OCOM DOTH OPTY OSCC lKJlND OCOM DOTH OPTY OSCC IK)IND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,O:..:6:.!/..:3:..:0C!./-=2..::0.=.1.:...7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 118 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16 .30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81.5°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 RECE)VED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION At;.ID EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) 05/31/2017 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 06/15/2017 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, 06/30/2017 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 v n fa I A 4 01/15/2017 Kaitlin Maley 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 Ka~t ~n Ma ey 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 CODE * IR]IND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC IKJIND DeOM DOTH DPTY osee IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY Dsec Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Call Taker and Records Specialist City Of San Rafael SUBTOTAL $ SCHEDULE A (CONT.) Statement covers period CALIFORNIA 460 FORM from 01/01/2017 through _....:0:...:6C!../.=.3.=.0,-,/ 2=.:0:.:1:..:7 __ _ Page 119 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE • PERIOD (IF REQUIRED) 16.30 195 .60 16 .30 195.60 16.30 195 .60 12.70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * 02/15/2017 Kaitlin Maley 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 02/27/2017 Kaitlin Maley C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/15/2017 Kaitlin Maley 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 n Rafael A 4 01 03/31/2017 Kaitlin Maley 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 Ka1t 1n Ma ey C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfi/e.com IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..::6-,-/-=.3.::..0/,-,2::.;0:..:1:...:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 120 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.5°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) 04/30/2017 05/15/2017 05/31/2017 06/15/2017 (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) Kaitlin Maley 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 Kaitlin Maley 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 Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, F' ·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 * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC !KlIND DCOM DOTH DPTY DSCC !KlIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0c..:6.!.../.=.3-,-,0 /'-.:2::..:0:..:1:...:.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 121 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.5°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 * 01/15/2017 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 01/31/2017 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, 02/15/2017 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 Aven e an Rafael CA 4 01 02/27/2017 Michael Mathis C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Ml.c ae Mat l.S C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·Contributor Codes IND -Individual . 4 COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6....:/,-3_0....:/_2_0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 122 of 19B I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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) IIF COMMITIEE , ALSO ENTER 1.0. NUMBER) CODE * 03/31/2017 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 04/14/2017 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, 04/30/2017 Fifth 05/15/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 M~c ae Mat ~s C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0;....6:....:/...:3;....0,-,/...:2:....:0...:1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 123 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 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) 06/15/2017 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 06/30/2017 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, 01/15/2017 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 Fif Av n n R f el A 01/31/2017 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 Ke y Maue 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 * [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC Corporal City of San Rafael Corporal City of San Rafael communications Dispatcher City of San Rafael communications Dispatcher City of San Rafael Commun~cat~ons D~spatc er City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~O~/_2_0_1_7 ______ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page __ -:;12::c4!... of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16.30 195.60 12.70 152 .40 12.70 152.40 12 .70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITTEE , ALSO ENTER 1.0 . NUMBER) 02/27/2017 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 03/15/2017 Kelly Mauel C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/31/2017 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 Fif h Avenue San Rafael A 4 01 04/14/2017 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 Ke y Maue 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 . R 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 * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY osee IXJIND DCOM DOTH DPTY osee IXJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY osee Communications Dispatcher City of San Rafael Communications Dispatcher 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 01/01/2017 through __ 0_6-,/_3_0-'./_2_0_1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 125 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 1 FPPC Form 460 (Jan/2016) FPpe 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 LD , NUMBER) CODE * 05/15/2017 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 05/31/2017 Kelly Mauel C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 Kelly Mauel C/o: San Rafael Police Association 1520 Fifth 06/30/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 94901 Fifth Fifth 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 Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael Communications Dispatcher City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6,-,/-=3:..:0,,-/..=2..:.0..:.1.:..7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 126 of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 16.30 195.60 67.1°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,ALSOENTERI.D NUMBER) CODE * 01/31/2017 Phillip Melodia C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/15/2017 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, 02/27/2017 03/15/2017 ·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 [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND 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 01/01/2017 through __ 0_6.!-/_3 -,0 /,-2_0_1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 127 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER I D. NUMBER) CODE * 04/14/2017 Phillip Melodia C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 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, 05/15/2017 05/31/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g .. business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o J.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:....6:...:/-=3:....0",/-=2:....:0-=1:....7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 128 Of_-=1::..:9:...:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE .ALSOENTERI,D.NUMBERI CODE * 06/30/2017 Phillip Melodia C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/15/2017 Beth Minka C/o: San Rafael Police Associ~tion 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/31/2017 02/15/2017 ·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 oCOM DOTH oPTY OSCC IKJIND oCOM DOTH oPTY oscc [RJIND oCOM DOTH oPTY OSCC [RJIND oCOM DOTH oPTY OSCC [RJIND oCOM DOTH oPTY OSCC Officer City of San Rafael Administrative Technician City of San Rafael Administrative Technician City of San Rafael Administrative Technician City of San Rafael A m1n1strat1ve Tec 1C1an City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0::..:6:..!/c..:3::..:O,-,/..:2:..:0:..:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 129 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 12.70 152 .40 12.70 152.40 12 .70 152.40 12 .70 152 .40 67.1°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 * 03/15/2017 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 03/31/2017 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, 04/14/2017 0 4 /30/2 0 17 ·ContributDr Codes IND -Individual COM -ReCipient Comm ittee (other than PTY or SCC) OTH -Other (e .g .. business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DpTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC Administrative Technician City of San Rafael Administrative Technician City of San Rafael Administrative Techni cian City of San Rafael Administrat i ve Technician City of San Rafael A m1n1strat1ve Tec 1C1an City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..6,,-,/c..:3:..O:.!/-=2::.:0:..:1::.:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page_-=13::;c0=-of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 -40 12.70 152.40 12 .70 152 .40 12 .70 152 .40 12 .70 152 .40 63 .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 I.D. NUMBER) 05/31/2017 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 06/15/2017 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, 06/30/2017 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, 1 20 Fi v n a 1 01/15/2017 Cynthia Morgan 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 Cynt l.a Morgan 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 OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC !XlIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Administrative Technician City of San Rafael Administrative Technician City of San Rafael Administrative Technician City of San Rafael Call Taker and Records Specialist City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0,-6:...:/...;3_0-,-/_2...;0..=1=-7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 131 of _-=1:.:9:...:8=-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152 .40 12.70 152.40 12.70 152.40 12.70 152 .40 63.50 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) (IFCOMMITTEE.ALSOENTERI,D ,NUMBER) CODE * 02/15/2017 02/27/2017 03/15/2017 03/31/2017 Cynthia Morgan C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Assoc i ation, 1520 Fifth Avenue San Rafael CA 94901 Cynthia Morgan 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 IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records Spec i alist City Of San Rafael Call Taker and Records Specialist City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/_2~0~1_7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 132 of _-=1.;.9!:.8 _ I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12 .70 152.40 1 2.70 152.40 12.70 152 .40 12.70 152.40 63.50 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) 04/30/2017 05/15/2017 05/31/2017 06/15/2017 (IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) Cynthia Morgan 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 Cynthia Morgan 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 Cynt ~a Morgan 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 * OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Call Taker and Records Specialist City Of San Rafael Call Taker and Records Specialist City Of San Rafael Call Taker and Records SpeCialist City Of San Rafael Call Taker and Records SpeCialist City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6-=/_3_0-,/_2...;0",1:....7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 133 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152 .40 12.70 152 .40 12.70 152 .40 12.70 152 .40 63.50 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 . NUM8ER) 01/15/2017 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 01/31/2017 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/15/2017 Fifth 02/27/2017 Fifth 03 15 2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·Contributor Codes IND -Individual . 4 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 * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY OSCC OOIND DCOM DOTH DPTY DSCC Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Menta Provider City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,O:..:6",/c...:3:..:0,-,/c...:2:.:0:.:1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 134 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 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 COMMIITEE. ALSO ENTER I.D. NUMBER) CODE * 03/31/2017 04/14/2017 04/30/2017 05/15/2017 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 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 2017 Lynn Murp y C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association , ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 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 Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0;:..6",/,-,3:....0:..:/-=2:....0;..;;1:....7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page _.....:.13~5~ of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152 .40 12_70 152.40 12 _70 152.40 12.70 152 AO 12_70 152_40 63_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 * 06/15/2017 06/30/2017 01/15/2017 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Lynn Murphy C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, Fifth 01/31/2017 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 02 15 2017 Jorge Navarro C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Mental Health Outreach Provider City of San Rafael Mental Health Outreach Provider City of San Rafael Evidence Technician City of San Rafael Evidence Technician City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0,-6,-,/....:3....:0,-,-/_2....:0",1=--7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 136 of _-=1:..:9:...:8,-- LO.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152 .40 12.70 152.40 12.70 152 .40 12.70 152 .40 63.5°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·EMPLOYEO. ENTER NAME OF BUSINESSI (IFCOMMITIEE,ALSO ENTER 1.0. NUMBERI CODE * 02/27/2017 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 03/15/2017 Jorge Navarro 03/31/2017 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 04/14/2017 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 04 30 2017 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, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Conlributor Committee www.netfile.com 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 Evidence Technician City of San Rafael Evidence Technician City of San Rafael Evidence Technician City of San Rafael Evidence Technician City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ O~6~/~3~O~/~2~O~1_7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 137 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 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 * 05/15/2017 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 05/31/2017 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 , 06/15/2017 06/30/2017 ·Conlributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contribulor Committee www.netfile.com Fifth Fifth Fifth IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Evidence Technician City of San Rafael Evidence Technician City of San Rafael Evidence Technician City of San Rafael Evidence Technician City of San Rafael Lea Commun~cat~ons Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0;....6:..:/-,3;....0;.:./-,-2-,0..;.1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 138 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152 .40 12 .70 152.40 12 .70 152.40 12.70 152 .40 12 .70 152 .40 63 .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 1.0. NUMBER) CODE * 01/31/2017 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 02/15/2017 Alexis Nielsen C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/27/2017 Alexis Nielsen C/o: San Rafael Police Association 1520 Fifth 03/15/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 94901 Fifth Fifth IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IXlIND OCOM DOTH OPTY OSCC IXlIND OCOM DOTH OPTY OSCC IXlIND OCOM DOTH OPTY OSCC Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lea Commun1cat1ons Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0",6:..!/-=3:...;0",/-=2:...;0",1:...;7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 139 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 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) (IFCOMMITTEE ,ALSO ENTER I O.NUMBER) CODE * 04/14/2017 Alexis Nielsen C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through i ntermedi ary : San Rafael Police Association, 1520 F i fth Avenue San Rafael CA 94901 04/30/2017 Alexis Nielsen C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 05/15/2017 05/31/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth OOIND DCOM DOTH DPTY DsCC [!lIND DCOM DOTH DPTY DSCC IXJIND DCOM DOTH DPTY DSCC IXJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Lead Communications Dispatcher City of San Rafael Lead Communicat i ons Dispatcher City of San Rafael Lead Communicat i ons Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lea Commun~cat~ons Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page __ --=.14.::.;0"-of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12 .70 152 .40 12 .70 152.40 12 .70 152 .40 12 .70 152 .40 63 .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) 06/30/2017 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 01/15/2017 Leslie O'Toole C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 01/31/2017 Fifth 02/15/2017 Fifth 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 CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Lead Communications Dispatcher City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ____ o6_/~3_0~/~2_0_1_7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 141 of __ ~1~9~8::....- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 77 .90 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3712) 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 )NDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE * 03/15/2017 Leslie O'Toole C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 03/31/2017 Leslie O'Toole C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 04/14/2017 Fifth 04/30/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Les l.e O'Too e 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 l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 142 of_-=1.;<.9",-S_ I.D.NUMBER S31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 B1.50 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) (IFCDMMITIEE,ALSO ENTER 1.0. NUMBER) CODE * 05/31/2017 Leslie O'Toole C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/15/2017 Leslie O'Toole 06/30/2017 01/15/2017 01 31 2017 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 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 OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6--=/_3_0-,/_2_0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 143 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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 * 02/15/2017 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 02/27/2017 Brian Patterson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association , 03/15/2017 Fifth 03/31/2017 Fifth 04 14 2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or seC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Off i cer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 144 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16 .30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR )F AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMmEE. ALSO ENTER 1.0 . NUMBER) 04/30/2017 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 05/15/2017 Brian Patterson 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 * OOIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer Ci ty of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0;:..6"'/'-'3;:..0'-'/....:2:..:0:..:1:..:7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 145 of _-=1:.:9:.:8=-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195 .60 16 .30 195 .60 16.30 195 .60 16.30 195.60 81. 50 I 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) (IFCOMMmEE.ALSOENTERI,O NUMBER) 01/15/2017 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 01/31/2017 Buffy Paxson 02/15/2017 02/27/2017 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 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 OOIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0-=6.!../.::.3.::.0 /,-,2:..:0-=1:..:.7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 146 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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 * 03/31/2017 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 04/14/2017 Buffy Paxson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael , CA 94901 Union member's dues rece i ved through interm7diary : San Rafael Police Association , 04/30/2017 Fifth 05/15/2017 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 OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC !K]IND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:..:6",/,-,3:..:0,-,/....:2:..:0:.:1:..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 147 of 198 I.D . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195 .60 16 .30 195 .60 81. 50 I 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 * 06/15/2017 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 06/30/2017 Buffy Paxson 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, 01/15/2017 Fifth 01/31/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 02 15 2017 Jess~ca Perry C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC !!lIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6,,-,/,-,3:..:0,-,/,-,2:..:0:..:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 148 Of _..=l.,:.9;<.8 _ I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER LD . NUMBER) CODE * 02/27/2017 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 03/15/2017 Jessica Perry C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary : San Rafael Police Association, 03/31/2017 04/14/2017 04 30 2017 ·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 IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJINO DCOM DOTH DPTY DSCC IRJINO DCOM DOTH DPTY DSCC IRJINO 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 01/01/2017 through __ 0:.:6::..;/:..:3:.:0::..;/....:2:.:0:.:1:.:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 149 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 1 .30 195.60 81. 50 I 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 * 05/15/2017 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 05/31/2017 Jessica Perry C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 Fifth 06/30/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 01 15 2017 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 [&lIND DCOM DOTH DPTY DSCC [&lIND DCOM DOTH DPTY DSCC [&lIND 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 Officer City of San Rafael Po ~ce corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 150 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195 .60 16.30 195 .60 16.30 195 .60 81. 50 I 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,ALSOENTERI.O.NUMBER) CODE * 01/31/2017 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 02/15/2017 Aaron Piombo C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/27/2017 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, 152 F ' h Av u n R A 4 03/15/2017 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 03 31 2017 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 seC) OTH -Other (e.g., business entity) PTY -Political Party see -Small Contributor Committee www.netfile.com !!lIND DCOM DOTH DPTY DSCC !!lIND DCOM DOTH DPTY DSCC IXJIND DCOM DOTH DpTY DSCC IXJIND DCOM DOTH DPTY DSCC !!lIND DCOM DOTH DPTY DSCC Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _...::0:..:6'-'./.::.3.::.0/'-.:2:..:0:..:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 151 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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) (IFCOMMmEE,ALSO ENTER I,D , NUMBER) CODE * 04/14/2017 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 04/30/2017 Aaron Piombo 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, 05/15/2017 Fifth 05/31/2017 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 2017 Aaron P10 0 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 !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DpTY DSCC IXJIND DCOM DOTH DPTY DSCC IXJIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael Police Corporal City of San Rafael Po 1ce corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0"-6=.;/'-'3:....0'-'/_2-'0;..:1:....7 ___ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 152 of 198 i.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECT)ON TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 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 ~F SELF·EMPLOYEO, EI'iTER NAME OF BUSINESS) (IF COMMITTEE, ALSO EI'iTER 1.0, NUMBER) 06/30/2017 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 01/15/2017 Dennis Prince 01/31/2017 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 02/15/2017 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 02 27 2017 Dennl.s Prl.nce 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 * !R]IND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC !R]IND DCOM DOTH DpTY DSCC !R]IND DCOM DOTH DPTY DsCC !R]IND DCOM DOTH DPTY DSCC Police Corporal 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 01/01/2017 through ___ 0_6~/~3_0~/_2_0_1_7 ____ ___ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page __ --=.15"-'3"-. of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN, 1 -DEC, 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0 NUMBER) 03/15/2017 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 03/31/2017 Dennis Prince 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, 04/14/2017 Fifth 04/30/2017 Fifth 05 15 2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, ·Contributor Codes IND-Individual 'f COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IRJIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC fRjlND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0::.c6:..!/c...:3::.c0:..!/...:2:.:0:..:1:.:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 154 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 16 .30 195 .60 81. 50 I 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) (IFCOMMmEE,ALsOENTERI.D.NUMBER) CODE * 05/31/2017 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 06/15/2017 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, 06/30/2017 Fifth 01/15/2017 Police Association 1520 Fifth 01 31 2017 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 OCOM DOTH OPTY OSCC [RJIND OCOM DOTH OPTY OSCC IXlIND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC IR]IND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0_6~/~3_0~/_2_0~1~7 ______ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page __ --=.15"-'5"-of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 16 .30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwJppc.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) 02/15/2017 Gino Rantissi c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/27/2017 Gino Rantissi 03/15/2017 03/31/2017 c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 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 04 14 2017 Gl.no Rantl.ssl. 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 OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6-'/'-3_0...:/-'2:....0'-'1_7 ___ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 156 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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 * 04/30/2017 Gino Rantissi c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/15/2017 Gino Rantissi c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/31/2017 Gino Rantissi c/o San Rafael Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 2 Fifth Avenue n R f 1 A 4 ° 06/15/2017 Gino Rantissi c/o San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 06 30 2017 G1no Rant1ss1 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 v (other than P1Y or SCC) OTH -Other (e.g .. business entity) P1Y -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OP1Y OSCC OOIND OCOM DOTH OP1Y OSCC OOIND OCOM DOTH OP1Y OSCC OOIND OCOM DOTH OP1Y OSCC OOIND OCOM DOTH OP1Y OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o 1cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..::6,,-/.::.3.::.0 /c..:2:..:O:.:1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 157 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 16.30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DAlE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 01/15/2017 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 01/31/2017 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, 02/15/2017 Fifth 02/27/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 Ron a 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, '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 !RlIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC !RlIND OCOM DOTH OPTY OSCC !RlIND OCOM DOTH OPTY OSCC !RlIND OCOM DOTH OPTY OSCC Corporal Ci ty of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _....:0....:.6..:.../.:..3_0/,-2_0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 158 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16 .30 195.60 16.30 195.60 16 .30 195.60 16 .30 195 .60 81. 50 I 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 BUSINESSI (IFCOMMITTEE ,ALSO ENTER 1.0. NUMBERI CODE * 03/31/2017 Ronda Reese C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermedi ary : San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 04/14/2017 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 , 04/30/2017 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 Fi Av n n R f A 4 ° 05/15/2017 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 Ron a 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, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Corporal City of San Rafael Corporal City of San Rafael Corporal City of San Rafael Corporal Ci ty of San Rafael Corpora City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:.:6,,-,/c...:3:.:O,-,/..:2:.:0:.:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 159 of 19B 1.0 . NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195 .60 16 .30 195 .60 16 .30 195 .60 B1. 50 I 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. Ef'lTER NAME OF BUSINESS) (IF COMMITTEE. ALSO Ef'lTER I O. NUMBER) CODE * 06/15/2017 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 06/30/2017 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, 01/15/2017 Fifth 01/31/2017 Fifth 02 15 2017 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 [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DpTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC Corporal City of San Rafael Corporal City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lea Commun1cat10ns Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6....:/_3_0-,-1_2_0_1_7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 160 of _....:1'-.:9:..::8'--. I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195 .60 12.70 152 .40 12.70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.goy (866/275-3772) www.fppc.ca.goY Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IFCOMMmEE. ALSO ENTER 1.0. NUMBER) CODE * 02/27/2017 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 03/15/2017 Peggy Ruge 03/31/2017 04/14/2017 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 04 30 2017 Peggy Ruge C/o : San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g .. business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY oscc OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC OOIND OCOM DOTH OPTY OSCC Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lea Commun1cat10ns Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ ~06~/~3~0~/~2~0~1~7~ ____ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 161 of __ ....:1,.,9,-,8,,-- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * 05/15/2017 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 05/31/2017 Peggy Ruge C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 06/30/2017 01 15 2017 ·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 OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael Lead Communications Dispatcher City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6,-,/...:3:...:0,-,/..:2:.:0:..:1:...:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 162 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 -22.40 156.90 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYEO. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTER 1.0 . NUMBER) CODE * 01/31/2017 02/15/2017 02/27/2017 03/15/2017 03 31 2017 Travis Ruggles C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94974 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Travis Ruggles C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94974 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 DCOM DOTH DPTY DSCC IKJINO DCOM DOTH DPTY DSCC IRJINO DCOM DOTH DPTY DSCC IRJINO DeOM DOTH DPTY DSCC IRJINO DCOM DOTH DPTY DSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:....6:...:/-=3:....0,-,/-=2:...:0",1:....7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 163 of 19B I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 156.90 16.30 156.90 16.30 156.90 16.30 156.90 16.30 156.90 81. 50 I FPPC Form 460 (Jan/20i6) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0 . NUMBER) 04/14/2017 Travis Ruggles C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94974 Union member's dues received through intermediary: San Rafael Police Association. 1520 Fifth Avenue San Rafael CA 94901 04/30/2017 Travis Ruggles C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94974 Union member's dues received through interm7diary : San Rafael Police Association. 05/15/2017 05/31/2017 06 15 2017 ·Contributor Codes INO -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Comm ittee www.netfile.com Fifth Fifth Fifth CODE * OOIND DCOM DOTH DPTY DsCC OOIND DCOM DOTH DpTY DSCC OOIND DCOM DOTH DpTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael Police Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:....6:...:/-=3:....0;..:./_2:....0..=1:....7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 164 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 156.90 16.30 156.90 16 .30 156 .90 16 .30 156 .90 16 .30 156 .90 81.50 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) 06/30/2017 01/15/2017 01/31/2017 02/15/2017 (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) Travis Ruggles C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94974 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 Thomas Sabido 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 CODE * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Police Officer City of San Rafael 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 01/01/2017 through __ 0::.:6",/c.:3::.:O:.!/...:2:..:0:.:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 165 of _....:1,,-,9::.:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 156.90 16.30 195 .60 16.30 195 .60 16,30 195.60 16.30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwJppc.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) 03/15/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 03/31/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member 's dues received through interm7diary: San Rafael Police Association, 04/14/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth 04/30/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 94901 Fifth Fifth CODE * IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IK]IND 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 01/01/2017 through ___ D_6~/_3_D~/_2_0_1_7 ______ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 166 of __ -,1'-.:9:.,:,8"- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16 .30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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 * 05/31/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/15/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/30/2017 Thomas Sabido C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1 2 . hAven n A 01 01/15/2017 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 Ant ony Sca erc~o C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·CDntributor Codes IND-Individual COM -Recipient Committee v (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6:..</..:3:..:0,-,/..:2:..:0:..:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 167 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 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) 02/15/2017 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 02/27/2017 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, 03/15/2017 03/31/2017 ·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 * IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0_6~/~3~0~/_2_0_1_7 ____ ___ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 169 of 199 I.D.NUMBER 931553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195. 0 81. 50 I 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 * 04/30/2017 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 05/15/2017 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, 05/31/2017 06/15/2017 ·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 DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJINO 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 01/01/2017 through __ 0:..6",/,-,3:..0,-,/...:2:..:0:..:1:..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 169 of 198 1.0 . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195.60 16.30 195.60 81.50 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 * 01/31/2017 Robert 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 02/15/2017 Robert 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, 02/27/2017 03/15/2017 ·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 [RJIND DCOM DOTH DPTY DSCC [RJIND 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 01/01/2017 through _-,0-=6.!.../.::..3 ",0/c...:2:..:O:..::1:...:.7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 1 7 ° of _....:1,.,9:..::8,-- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 179.30 16.30 179 .30 16.30 179.30 16 .30 179.30 16 .30 179.30 81.50 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) CODE * 04/14/2017 Robert 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 04/30/2017 Robert 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, 05/15/2017 05/31/2017 ·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 IXlIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IK]IND 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 01/01/2017 through __ 0::.c6:..!/c...:3::.c0:..!/c...:2:..:O:..:1:..:7 ___ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 171 of _....::1,-,9:..::8:........ I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 179.30 16.30 179.30 16.30 179.30 16.30 179.30 16.30 179.30 B1. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) (IF COMMITTEE . ALSO ENTER I.D. NUMBER) CODE * 06/30/2017 Robert 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 01/15/2017 George Schikore C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 01/31/2017 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 Av S n 1 A 1 02/15/2017 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 02 27 2017 George Sc ~ 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 [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC [KJIND 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 ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 th rough __ 0=-6~/,-,3=-0:..:/--=2=-0:..:1=-7,--__ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page _----=-1..:..;72=__ of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16_30 179.30 16_30 195.60 16_30 195.60 16 .30 195.60 16.30 195.60 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 COMMITIEE, ALSO ENTER 1.0. NUMBER) 03/15/2017 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 03/31/2017 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, 04/14/2017 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, 1 20 Fi v n e an 1 CA 04/30/2017 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 05 15 2017 George Sc l. 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, ·CDntributor Codes IND -Individual COM -Recipient Committee (other than PTY or seC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IRJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC [RJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer Ci ty of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ______ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 173 of 198 LD .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16 .30 195 .60 16 .30 195 .60 16 .30 195 .60 81. 50 I 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 0 NUMBER) 05/31/2017 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 06/15/2017 George Schikore C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/30/2017 Fifth 01/15/2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 01 31 2017 Just~n Sc rae er C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * !R]IND DCOM DOTH DPTY DSCC !R]IND DCOM DOTH DPTY DSCC !R]IND DCOM DOTH DpTY DSCC !R]IND DCOM DOTH DPTY DSCC !R]IND 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 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 174 of _...:1",9:..08,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195 .60 16 .30 195.60 16.30 195 .60 81.50 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 BUSINESSI (IF COMMITIEE, ALSO ENTER I.D. NUMBERI 02/15/2017 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 02/27/2017 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, 03/15/2017 Fifth 03/31/2017 Fifth 04 14 2017 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 'CDntributDr 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 * OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DpTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Officer City of San Rafael 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 01/01/2017 through _-=0:..=6~/.::.3.::.0 /:..;2:;.:0:..=1:.c.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 175 of _...:10..:9::..:8"---- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81.50 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 * 04/30/2017 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 05/15/2017 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, 05/31/2017 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 Fif h Av n n R fa 1 CA 4 1 06/15/2017 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 30 2017 Just1.n Sc rae er C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 'Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6-..-'/_3_0-,/_2_0_1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 176 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16 .30 195.60 16.30 195 .60 16 .30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSO ENTER 1.0. NUMBER) CODE * 01/15/2017 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 01/31/2017 Wanda Spaletta C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 02/15/2017 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 F'f h Av u n R f A 02/27/2017 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 OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DpTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:..:6,-,/....:3:..:0,-,/....:2:.:0:..:1:...:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 177 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC, 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 16.30 195.60 81. 50 I 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. NUMBERI CODE * 03/31/2017 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 04/14/2017 Wanda Spaletta C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 04/30/2017 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 F' h Av nu 1 A 4 05/15/2017 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 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 see -Small Contributor Committee www.netfile.com !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC !&lIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ O:..:6:..!/c...:3:..:O,,-,/....:2:.:0:..:1:.:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 17B of 19B I.D.NUMBER B31553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195_60 16_30 195.60 16.30 195.60 16.30 195.60 16_30 195.60 81. 50 I 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 * 06/15/2017 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 06/30/2017 Wanda Spaletta 01/15/2017 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, 1 20 Fif h Av n e Sa A 4 1 01/31/2017 Lynette Starnes 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 02 15 2017 Lynette Starnes 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 !RlIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC [KJIND OCOM DOTH OPTY OSCC !RlIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Community Service Officer 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 01/01/2017 through _-,O::..;6:..!/...:3:....:0:..!./...:2:..:0:..:1:..:.7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 179 of _-=1:..:9:..:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195.60 16 .30 195.60 12.70 152.40 12.70 152.40 12.70 152.40 70.70 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) 02/27/2017 03/15/2017 03/31/2017 04/14/2017 04 30 2017 (IF COMMITTEE , ALSO ENTER 1.0. NUMBER) Lynette Starnes 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 Starnes 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 CODE * IK]IND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IK]IND OCOM DOTH OPTY OSCC Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Commun~ty Serv~ce 0 ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ O:..:6:..!/~3:..:0:..!/...:2:..:0:..:1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 180 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12.70 152 .40 12 .70 152 .40 12 .70 152.40 63.50 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) (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * 05/15/2017 Lynette Starnes 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 05/31/2017 Lynette Starnes C/o; San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 06/15/2017 Lynette Starnes 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 F'f Av nue n R f 1 CA 4 1 06/30/2017 Lynette Starnes 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 01 15 2017 Rem1ngton Sto 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 OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael Community Service Officer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through ___ 0~6~/~3~0~/~2~0~1~7 ____ ___ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page '181 of 198 tD. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12 .70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 16.30 195.60 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 COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 01/31/2017 02/15/2017 02/27/2017 03/15/2017 Remington Stobo 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 Remington Stobo 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 03 31 2017 Reml.ngton Sto 0 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 !KlIND DCOM DOTH DPTY DSCC !KlIND DCOM DOTH DPTY DSCC IXlIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC !KlIND DCOM DOTH DPTY DSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0_6--,/,--3_o-,/_2 __ 0_1_7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 182 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195.60 16.30 195 .60 16.30 195 .60 16 .30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca .gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSO ENTER 1.0 . NUMBER) CODE * 04/14/2017 Remington Stobo 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 04/30/2017 Remington Stobo C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/15/2017 Fifth 05/31/2017 Fifth 06 15 2017 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 [!lIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC [!lIND OCOM DOTH OPTY OSCC [!lIND OCOM DOTH OPTY OSCC [!lIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael Police Officer City Of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-'0:..:6",/,-,3:..:0,-,/,-,2:.:0:..:1:..:7 __ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 183 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81. 50 I 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) 06/30/2017 01/15/2017 01/31/2017 02/15/2017 (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) Remington Stobo C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael , CA 94901 Union member's dues received through intermedi ary: San Rafael Police Associat i on, 1520 Fifth Avenue San Rafael CA 94901 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, 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 CODE * IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC IRJIND OCOM DOTH OPTY OSCC Police Officer City Of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0:.:6:.!/-=3:.:0:..!./-=2:..:0c::1:...:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 184 of _...:1""9,,,,8,- I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195 .60 16.30 195 .60 16 .30 195.60 16.30 195 .60 16 .30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.90v (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * 03/15/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 03/31/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary : San Rafael Police Association, 04/14/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 152 Fi Av n A 4 01 04/30/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 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 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 01/01/2017 through _--,0::..:6,-,/...:3:..:0,-,/...:2:.:0:..:1:..:7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 185 of 198 I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 16 .30 195.60 81. 50 I 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 * 05/31/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael , CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 06/15/2017 Christopher Sweeney C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 06/30/2017 01/15/2017 ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e .g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com Fifth Fifth Fifth IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Civilian Supervisor City of San Rafael C1V1 1an Superv1sor City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0c.::6.!../.::.3 ,,-,0 /:..:.2:..:0:.:1:..:.7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 186 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195 .60 12.70 152.40 12.70 152.40 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSO ENTER 1.0 . NUMBER) CODE * 02/15/2017 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 02/27/2017 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. 03/15/2017 03/31/2017 ·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 Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael C~v~ ~an Superv~sor City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _...:0:...:6,,-/.::.3.::.0/'-.:2:..:0:...:1:..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 187 of 198 I.D. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152 .40 12.70 152.40 12.70 152.40 12.70 152.40 12.70 152.40 63.5°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 COMMITIEE , ALSO ENTER 1.0. NUMBER) 04/30/2017 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 05/15/2017 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, 05/31/2017 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 F'f Av n fa A 4 01 06/15/2017 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 C ar y Tay or C/o: San Rafael Police Association 1520 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 94901 CODE * [RJIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC [KJIND DCOM DOTH DPTY DSCC OOIND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael Civilian Supervisor City of San Rafael C1Vl lan Supervlsor City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _--'0:.;6'-'/-=3-=0-'-/.::2-=.0.::17-'--__ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 18 8 of _-,1::..:9::..:B=--- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12.70 152.40 12.70 152.40 12 .70 152.40 12.70 152.40 12.70 152.40 63.50 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) IIFCOMMITTEE,ALSOENTER 1.0. NUMBER) CODE * 01/15/2017 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 01/31/2017 Henry Tirre 02/15/2017 02/27/2017 03 15 2017 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, F' 4 ·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 IK]IND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IKJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0"-6"'/'-'3:....0:..:/--=2:..;0:....:1:....7 ___ _ SCHEDULE A (CO NT.) CALIFORNIA 460 FORM Page 189 of _-=1:..:9",,8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16 .30 195.60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED, ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTERI.D.NUMBER) CODE * 03/31/2017 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 04/14/2017 Henry Tirre 04/30/2017 05/15/2017 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 05 31 2017 Henry Tl.rre 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 . 4 COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g .. business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC IKJIND OCOM DOTH OPTY OSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _--,0:....:6,",-/..:.3..:.0,-,/2=-0:....:1:..:7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 19 ° of _....:1:,.:9:..:;8=- I.D . NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 .30 195 .60 16 .30 195.60 16 .30 195 .60 16.30 195.60 16 .30 195 .60 81. 50 I 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 * 06/15/2 017 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 06/30/2017 Henry Tirre C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association. 01/15/2017 Fifth 01/31/2017 Fifth 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 !RlIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC !RlIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ ~0~6~/~3~0~/~2~0~17~ ____ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 191 of 198 I.D .NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16 _30 195 .60 16.30 195_60 16_30 179 .30 16_30 179 _30 16.30 179 _30 8L501 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) 02/27/2017 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 03/15/2017 Michael Vergara C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 03/31/2017 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, 2 Fifth Av R f 1 CA 4 01 04/14/2017 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 M~c ae 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, ·Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g., business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com CODE * IKJIND OCOM OaTH OPTY OSCC IKJIND OCOM OaTH OPTY OSCC IK]IND OCOM OaTH OPTY OSCC IKJIND OCOM OaTH OPTY OSCC IKJIND OCOM OaTH OPTY OSCC Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael Sergeant City of San Rafael sergeant City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0:...6:..:/-=3:...0,-,/-=2:....:0",1:...7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page 192 of _-=1::..:9:..;:8,-- I.D.NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 179.30 16.30 179.30 16.30 179.30 16.30 179.30 16.30 179.30 81. 50 I 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·E ... PLOYED . ENTER NAME OF BUSINESS) (IF CO ...... ITIEE. ALSO ENTER 1.0. NU ... BER) CODE * 05/15/2017 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 05/31/2017 Michael Vergara 06/15/2017 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, 20 Fifth Av n 1 A 4 01 01/15/2017 Mark Wilkinson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Mar Wl. l.nson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through interm7diary: San Rafael Police Association , ·Contributor Codes IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g .• business entity) PTY -Political Party SCC -Small Contributor Committee www.netfile.com 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 Sergeant City of San Rafael Sergeant City of San Rafael Officer City of San Rafael o l.cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through _-,0....:6.!../.c..3 -,,0 /,-2-,0,-1_7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 193 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 179.30 16.30 179.30 16.30 179.30 16.30 195.60 16.30 195 .60 81. 50 I FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO. ENTER NAME OF BUSINESS) (IFCOMMITIEE,ALSOENTER 1.0 . NUMBER) CODE * 02/15/2017 Mark Wilkinson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 02/27/2017 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, 03/15/2017 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, 15 0 Fif h Av n f 1 A 4 1 03/31/2017 Mark Wilkinson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael, CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 Mar Wl. l.nson 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 F' 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 01/01/2017 through __ O:..:6:..!/....:3....:0,,-/-=2..:.0.::.1.:...7 __ _ SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 194 of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 81.50 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3n2) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER San Rafael Police Association Political Action Committee Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYED. ENTER NAME OF BUSINESS) (IFCOMMITTEE,ALSOENTER 1.0 . NUMBER) CODE * 04/30/2017 Mark Wilkinson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through intermediary: San Rafael Police Association, 1520 Fifth Avenue San Rafael CA 94901 05/15/2017 Mark Wilkinson C/o: San Rafael Police Association 1520 Fifth Avenue San Rafael. CA 94901 Union member's dues received through interm7diary: San Rafael Police Association, 05/31/2017 06/15/2017 ·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 IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC IRJIND DCOM DOTH DPTY DSCC Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael Officer City of San Rafael o ~cer City of San Rafael SUBTOTAL $ Statement covers period from 01/01/2017 through __ 0.:..6",/,-3:....0,-,/-,2-,0-,1:....7 __ _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM Page _--=.19::..;5=-of 198 1.0. NUMBER 831553 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN . 1 • DEC . 31) PER ELECTION TO DATE (IF REQUIRED) 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195.60 16.30 195 .60 81.5°1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E ScheduleE Payments Made Amounts may be rounded to whole dollars. Statement covers period from 01/01/2017 CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE thro ug h _-'0-=6.:../.=.3.=.0:..../2=..0"'1=..7'--__ 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. eM' 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 F£T petition circulating lEL t. v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks lRC cand idate travel , lodging , and meals FND fundraising events POL polling and survey research TRS staff/spouse travel , lodging , and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads IJ\i83 information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER 1.0 . NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Donor Stack, LLC WEB 78.62 5940 College Avenue, Suite F Oakland, CA 94618 Donor Stack, LLC WEB 183.32 5940 College Avenue, Suite F Oakland, CA 94618 Donor Stack, LLC WEB 79.04 5940 College Avenue, Suite F Oakland, CA 94618 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 340 .98 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ ___ ---=2:..!,.:1:.:6..::9.:. • .=.0.=.4 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 $ ___ --=2:..!,.:1:.:6.=.9,..;. . ..::.0..::.4 www.netfi/e.com FPPC Form 460 (Jan/2016) FPPC Toll-Free Helpline: 866/ASK·FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SCHEDULE E (CONT.) Amounts may be rounded to whole dollars. Statement covers period from 01/01/2017 CALIFORNIA 460 FORM I SEE INSTRUCTIONS ON REVERSE through 06/30/2017 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 FET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals INO independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads II'v£B information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) Donor Stack, LLC WEB 5940 College Avenue, Suite F Oakland, CA 94618 Donor Stack, LLC WEB 5940 College Avenue, Suite F Oakland, CA 94618 The Henry Levy Group PRO 5940 College Avenue Oakland, CA 94618 The Henry Levy Group PRO 5940 College Avenue Oakland, CA 94618 • Payments that are contributions or independent expenditures must also be summarized on Schedule D. www_netfile_com OR DESCRIPTION OF PAYMENT AMOUNT PAID 52.57 131.99 1,091.45 552.05 SUBTOTAL $ 1,828.06 FPPC Form 460 (Jan/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE. ALSO ENTER 1.0 , NUMBER) Amounts may be rounded to whole dollars. Statement covers period from 01/01/2017 through 06/30/2017 DESCRIPTION OF RECEIPT I Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule I Summary 1. Itemized increases to cash this period ........................................................................................................................ $ _____ .::..0:....:.0=0 2. Unitemized increases to cash of under $1 00 this period ............................................................................................. $ _____ .::...3;;...:. 0~4 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 $ _____ .::..3:....:.0:....::.4 SCHEDULE I CALIFORNIA 460 FORM Page~of ~ I.D .NUMBER 831553 AMOUNT OF INCREASE TO CASH www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov