HomeMy WebLinkAboutForm 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