HomeMy WebLinkAboutForm 460 - Police Association PAC (2018-09-22) 1st Preelection StatementRecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 07/01/2018
through 09/22/2018
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
0 Recall 0 Controlled
(Also Complete Part 5) 0 Sponsored
(Also Complete Part 6)
Fx-] General Purpose Committee
tx) Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
3. Committee InformationI I.D. NUMBER
831553
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO P.O. BOX)
STATE
ZIP CODE
AREA CODE/PHONE
CA
94901
(
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Oakland
CA
94618
(
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the in4rmation contain d herein and in the attached schedules is true and complete. I certify
under penalty of perjury under the laws of the State of California that the foregoing is true and correct. r
Executed on 09/24/2018 By 1
Date i n o sur ITreasurer
Executed on 09/24/2018 By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible ORcerof Sponsor
Executed on 8y
Data Signature of Controlling Officeholder. Candidate. Stale Measure Proponent
Executed on
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By
Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
COVER PAGE - PART 2
CALIFORNIA
FORM ' 60
Page 2 of 71
5. Officeholder or Candidate Controlled Committee
6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT
❑ SUPPORT
❑ OPPOSE
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
❑ SUPPORT
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
Related Committees Not Included in this Statement: List any committees
❑ OPPOSE
not included in this statement that are controlled by you or are primarily formed to receive
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
❑ OPPOSE
7. Primarily Formed Candidate/Officeholder Committee List names of
NAME OF TREASURER CONTROLLED COMMITTEE?
officeholder(s) or candidate(s) for which this committee is primarily formed.
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
[:] SUPPORT
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER I ❑ F-1CONTROLLED COMMITTEE?
YES NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O- BOX)
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
F-1 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
Expenditures Made
6. Payments Made .......................................................
Column A
Contributions Received
Schedule H. Line 3
8. SUBTOTALCASH PAYMENTS ....................................
TOTALTHISPERIOD
9. Accrued Expenses (Unpaid Bills) ...............................
Schedule F, Line 3
10. Nonmonetary Adjustment ..........................................
(FROM ATTACHED SCHEDULES)
1. Monetary Contributions ...........................................
Schedule A, Line 3
$
4,824.90
2. Loans Received......................................................
Schedule e, Line 3
0.00
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1+2
$
4,824.90
4. Nonmonetary Contributions ....................................
Schedule c, Line 3
0.00
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines 3+4
$
4,824.90
Expenditures Made
6. Payments Made .......................................................
Schedule E, Line 4 $
7. Loans Made.............................................................
Schedule H. Line 3
8. SUBTOTALCASH PAYMENTS ....................................
Add Lines 6+7 $
9. Accrued Expenses (Unpaid Bills) ...............................
Schedule F, Line 3
10. Nonmonetary Adjustment ..........................................
Schedule C, Line 3
11. TOTAL EXPENDITURES MADE...... .............
-- ........ Add Lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $
13. Cash Receipts ................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash ........................... Schedule 1, 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
1,595.86
0.00
1,595.86
-146.35
Statement covers period
from 07/01/2018
through
Column B
CALENDAR YEAR
TOTALTODATE
$ 19,561.20
0.00
$ 19,561.20
0.00
$ 19,561.20
$ 3,826.43
0.00
$ 3,826.43
0.00
0.00 0.00
1,449.51 $
95,266.82
4,824.90
1.63
1,595.86
98,497.49
0.00
0.00
0.00
3,826.43
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
SUMMARYPAGE
09/22/2018 Page 3 of 71
I.D. NUMBER
831553
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $ _
21. Expenditures
Made $ $ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy) Q
IF I $
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Srhprli ilp A
SCHEDULE A
Amounts may be rounded
Monetary Contributions Received
Statement covers period
CALIFORNIA
to whole dollars.
460
from 07/01/2018
FORM
through 09/22/2018
Page 4 of 71
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
AND
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
(E COMMITTEE, ALSO I.D.NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Elisha Adams
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
07/31/2018
Elisha Adams
❑x IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
❑ OTH
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
08/15/2018
Elisha Adams
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1-;')n Fifth Avpnlip Ran RafaP1 CA 94901
❑ SCC
08/31/2018
Elisha Adams
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 15 2018
Raul Aguilar
MIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Aypnijp. San Rafael. C&_343_Gl__
❑ SCC
SUBTOTAL$ 81.50
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ........................................ $ 4,799.50
2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $
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25.40
4,824.90
'Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY— Political Party
SCC —Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
towholedollars.
I'
from 07/01/2018
through 09/22/2018
page 5 of
71NAME
OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERI.D.NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN- 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Raul Aguilar
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Raul Aguilar[X]IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
08/31/2018
Raul Aguilar
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
E] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Anthony Augustyn
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 FifthE]
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 31 2018
Anthony Augustyn
[K]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PN
intermediary: San Rafael Police Association,
[]SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC-- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
a
to whole dollars.
I'
from 07/01/2018
'
IPge
through 09/22/2018
6 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
RE ADDRESSZIPO
AIF
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(EET
IT I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Anthony Augustyn
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Anthony AugustynX❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael. CA 94901
❑ SCC
07/15/2018
James Bellamy
X❑IND
Corporal
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94 901
07/31/2016
James Bellamy
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 FifthE]
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
James Bellamy
X❑IND
Corpora
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue,n Rafael. CA 94901
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 7 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
A S
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(ET
COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
James Bellamy
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
E] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Todd Berringer
KIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
Rafael.1 520 Fifth Avenue, San
❑ SCC
07/31/2018
Todd Berringer
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue an Rafael CA 94901
08/15/2018
Todd Berringer
MIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
To Berringer
MINDSergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
/ � '
from 07/01/2019
• "
through 09/22/2018
Page 8 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND ZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO ENTER
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Lynne Bracken
X❑IND
Call Taker & Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
[:]OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Lynne Bracken
MIND
Call Taker & Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
❑ OTH
City of San Rafael
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael. CA 94901
❑ SCC
08/15/2018
Lynne Bracken
x❑IND
Call Taker & Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Lynne Bracken
MIND
Call Taker & Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07715/2018
Zachary Bric a
MIND
icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PN
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
ElSCC
SUBTOTAL$ 67.10
`Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC— Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
/ 1
from 07/01/2018
F
through 09/22/2018
9 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVETO DATE
PER ELECTION
DATE
(E COMMITTEE, ALSENTERI.D.NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE*
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Zachary Brickell
]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Zachary Brickell
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
[:]SCC
08/31/2018
Zachary Brickell
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Rudolf Buhlman
x❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Rudolf Bu man
X❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
City Of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 FifthAvenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA
to whole dollars.
I � '
from 07/01/2018
• '
through 09/22/2018
page 10 Of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I. D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Rudolf Buhlman
FK] IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
El COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Rudolf Buhlman
RIND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
11;20 Fifth Avenue. San Rafael. CA 94901
❑ SCC
07/15/2018
Antonette Bullock
x❑IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
07/31/2018
Antonette Bullock
X❑IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
.Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Antonette Bu oc
[K]IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 70.70
*Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA li
to whole dollars.
I '
from 07/01/2018
'
through 09/22/2018
Page 11 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CU MULATIVETO DATE
PER ELECTION
(IF COMMITTEE, ALSO ENTER I D. NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Antonette Bullock
]IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Shelly Cade
X❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael,1520 Fifth Avenue. San
❑ SCC
07/31/2018
Shelly Cade
x❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 4901
08/15/2018
Shelly Cade
X❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Shelly Ca a
X❑IND
Dispatc er
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 63.50
*Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT)
Monetary Contributions Received Amounts may be rounded
statement covers period
•
to whole dollars.
I '
from 07/01/2018
•
through 09/22/2018
Page 12 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(ETITEALSNTERI.D.NUMBER)
CODE*
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN- 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Joseph CaminsX❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
E] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Joseph Caminsx❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth AvRnue. San
❑ SCC
08/15/2018
Joseph Camins
x❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue n Rafael CA 94901
08/31/2018
Joseph Camins
E] IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07715/2018
Trevor Carney
]IND
Police Off -icer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
City Of San Rafael
❑ COM
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1S20 Fifth Avenue,
❑ SCC
SUBTOTAL $ 81.50
'Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
_
to whole dollars.
'AM '
from 07/01/201e
� "
through 09/22/2018
page 13 of_ 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE ALSO ENTER .D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Trevor Carney
x❑IND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Trevor Carney
x❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.Ir9.0 Fifth Avenue. San
❑ SCC
08/31/2018
Trevor Carney
x❑IND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Jack Carpenter
x❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/2018
Jac Carpenter
[K]IND
0 icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM -- Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
• _
to whole dollars.
I '
from 07/01/2018
• "
through 09/22/2018
page 14 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERI.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Jack Carpenter
]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Jack Carpenter[K]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael, CA 94901
❑ SCC
07/15/2018
Edward Chiu
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Edward Chiu
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Edward Chiu
X❑IND
0 icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
❑ SCC
2Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
I '
from 07/01/2018
'
through 09/22/2018
page 15 of ?'
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVETO DATE
PER ELECTION
DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Edward Chiu
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Robert Cleland[X]IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue,1920 Fifth Rafael.
❑ SCC
07/31/2018
Robert Cleland
x❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/15/2018
Robert Cleland
RIND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
Robert Cleland
X❑IND
Police Co rporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL $ 81.50
'Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
towholedollars.
I 1
from 07/01/2018
• "
through 09/22/2018
Page 16 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Christopher Coale
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
E] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Christopher Coale
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1S20 Fifth Avenue. San
[:JSCC
08/15/2018
Christopher Coale
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Christopher Coale
]IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[]SCC
1520 Fifth Avenue, San Rafael, CA 94901
07715/2018
Thomas Collins
RIND
O icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
• _
NIA
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 17 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE. ALSO ENTER I D, NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Thomas Collins
X❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Thomas CollinsX❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael, CA 94901
❑ SCC
08/31/2018
Thomas Collins
X❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
(-]PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Jenna Cotta
X❑IND
Communications Dispatcher
'San
12.70
203.20
c/o San Rafael Police Association 1520 Fifth❑
COM
City of Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/201B
Jenna Cotta
X❑IND
Communications Dispatcher
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue.
SUBTOTAL$ 74.30
*Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period7NU
_towholedollars.from
07/01/2018through
09/22/2018
18 ofNAME
OF FILER
RSan
Rafael Police Association Political Action Committee
AND
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
TO DATE
DATE
(E COMMITTEE. ALSO LD NUMBER)
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Jenna Cotta
FK] IND
Communications Dispatcher
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Jenna Cotta
%❑IND
Communications Dispatcher
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
07/15/2018
Ryan De Marta
x❑IND
Officer
16.30
260.60
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
07/31/2018
Ryan De Marta
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
F] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Ryan De Marta
x❑IND
0 icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
ElSCC
SUBTOTAL$ 74.30
"Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
a _
to whole dollars.
I '
from 07/01/2016
through 09/22/2018
page 19 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERIDNUMBER)
CODE*
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Ryan De Marta
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Elisa Delatorre
MIND
Call Taker And Records
12.70
177.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
ic;?n Pift-h Avenue. San Ra4apl, CA 94901
❑ SCC
07/31/2018
Elisa Delatorre
x❑IND
Call Taker And Records
12.70
177.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
AvenueCity
Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Elisa Delatorre
MIND
Call Taker And Records
12.70
177.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
San Rafael, CA 94901
❑ OTH
City Of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
Elisa Delatorre
MIND
CaTaker An Records
12.70
177.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
San Rafael, CA 94901
❑ OTH
City Of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
ElSCC
SUBTOTAL$ 67.10
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
• _
to whole dollars.
I � ,
from 07/01/2018
•
through 09/22/2018
page 20 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Blake Delzell
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Blake Delzell
MIND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
[:]COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
Avenue.1520 Fifth Rafael.
❑ SCC
08/15/2018
Blake Delzell
[k]IND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/31/2018
Blake Delzell
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Danielle Dennis
MIND
Call Taker/Records
12.70
152.40
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
San Rafael, CA 94901
❑ OTH
City Of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 77.90
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
460
from 07/01/2018
FORM
through 09/22/2018
Page 21 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ADDRESSZIP
A
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
ITTEE D NUMBER)
(IF COMMITTEE.
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Danielle Dennis
]IND
Call Taker/Records
12.70
152.40
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Danielle Dennisx❑IND
Call Taker/Records
12.70
152.40
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael. CA 94901
❑ SCC
08/31/2018
Danielle Dennis
RIND
Call Taker/Records
12.70
152.40
C/o: San Rafael Police Association 1520 Fifth
[-]COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Christian Diaz
X❑IND
Sergeant
16.30
260.60
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/2018
Christian Diaz
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, 4
SUBTOTAL$ 70.70
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.neffile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA
to whole dollars.
I '
from 07/01/2016
• '
through 09/22/2018
Page 22 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
IT I.D. NUMBER)
(IF COMMITTEE,
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Christian Diaz
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Christian Diaz[X]IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San Rafael. CA 94901
[]SCC
07/15/2018
Justin Dodson
RIND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Justin Dodson
RIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Justin Dodson
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 F'Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
• _
NIA
to whole dollars.
I ,
from 07/01/2018
• "
through 09/22/201e
Page 23 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
,
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Justin Dodson
x❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth[-]
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
James Dooley
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael,1520 Fifth Avenue. San
[-]SCC
07/31/2018
James Dooley
%❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
CO M
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/15/2018
James Dooley
®IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
James Dooley
[K] IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
City Of San Rafael
Avenue
COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. 4
SUBTOTAL$ 81.50
*Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
• _
towholedollars.
I ,
from 07/01/2018
•
through 09/22/2018
page 24 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A SS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(ET
COMMITTEE, ANTERt.D.NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Christopher Duncan
X❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Christopher Duncan
RIND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San Rafael. CA 94901
❑ SCC
08/15/2018
Christopher Duncan
X❑IND
Police Corporal
16-30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Christopher Duncan
FK] IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 15/2018
Scott Eberle
X❑IND
Lieutenant
16.30
211.90
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
[]SCC
SUBTOTAL$ 81.50
`Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
e
to whole dollars.
I 0 '
from 07/01/2018
• '
through 09/22/2018
page 25 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITEE,ALSO ENTER LID NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Kevin Finerty
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Kevin Finerty
MIND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1920 Fifth Avenue. San
❑ SCC
08/15/2018
Kevin Finerty
x❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Kevin Finerty
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Scott Fis erMINDPo
ice Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue,n Rafael,
SUBTOTAL $ 81.50
*Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 26 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO ENTER ,D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Scott Fisher
MIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Scott Fisher
MIND
Police Officer
16-30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
❑ OTH
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.
❑ SCC
08/31/2018
Scott Fisher
g❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Anna Fulgado
MIND
Dispatcher
12.70
203.20
C/O: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Anna Fu ga o
MIND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
El COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. 4
SUBTOTAL$ 74.30
'Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
e
to whole dollars.
from 07/01/2018
• '
through 09/22/2018
page 27 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
A S
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(ET
COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN, 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Anna Fulgado
MIND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Anna Fulgado
MIND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafapl- CA 94901
❑ SCC
07/15/2018
Christopher Fuller
MIND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Christopher Fuller
MIND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTy
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Christopher Fu er
MIND
16.30
260.80
Clo: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
City
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 74.30
'Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period I
CALIFORNIA
towholedollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 2B of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND ZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO ENTER
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Christopher Fuller
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Salvatore Garanzini
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San Rafael. CA 94901
❑ SCC
07/31/2018
Salvatore Garanzini
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Salvatore Garanzini
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
Salvatore Garanzini
X❑IND
officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
❑ COM
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue.
SUBTOTAL $ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers periodCAL
FORNIA
to whole dollars.
I '
from 07/01/2018
ORM
through 09/22/2018
Page 29 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Michael Garrison
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Michael Garrisonx❑IND
Officer
16.30
260.60
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.IS20 Fifth
❑ SCC
08/15/2018
Michael Garrison
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Michael Garrison
®IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Lilah Gav is
X❑IND
Police Corpora
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
[-]COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
• _
towholedollars.
I ,
from 07/01/2018
• '
through 09/22/2018
Page 30 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE. ALSO ENTERS D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Lilah Gavlick
X❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Lilah Gavlick
X❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael. CA 94q01
❑ SCC
08/31/2018
Lilah Gavlick
%❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94 901
07/15/2018
Justin Graham
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/2018
Justin Graham
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
CALIFORNIA 460 � '
from 07/01/2018
"
through 09/22/2018
Page 31 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
PER ELECTION
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OCCUPATION AND EMPLOYER
CALENDAR YEAR
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Justin Graham
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Justin GrahamX❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
07/15/2018
Lori Hendricks
RIND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94935
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
07/31/2018
Lori Hendricks
X❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94935
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Lori Hendricks
X❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94935
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
ElSCC
SUBTOTAL$ 70.70
'Contributor Codes
IND -Individual
COM- Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period
a
to whole dollars.
I '
from 07/01/2018
through 09/22/2018
Page 32 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE ALSO ENTER .D NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Lori Hendricks
X❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94935
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Robert HenkleX❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San RafaF-1. CA 94901
❑ SCC
07/31/2018
Robert Henkle
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Robert Henkle
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
Robert Henkle
g] IND
O icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
ElSCC
SUBTOTAL$ 77.90
'Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
/ ,
from 07/01/2018
• "
through 09/22/2018
Page 33 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I. D. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN.1-DEC, 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
J. Alexander Holm
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[]PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
J. Alexander Holm
%❑IND
Corporal
16-30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
08/15/2018
J. Alexander Holm
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
El COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 4 01
08/31/2018
J. Alexander Holm
%❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Lisa Holton
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 81.50
'Contributor Codes
IND— Individual
COM -- Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY— Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
460 � '
from 07/01/201B
• '
through 09/22/2018
Page 34 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER 1.0 NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. I -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Lisa Holton
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Lisa Holton
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue,1520 Fifth Rafael.
❑ SCC
08/31/2018
Lisa Holton
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
07/15/2018
Carl Huber
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Carl Huber
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
❑ SCC
SUBTOTAL$ 81.50
"Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
towholedollars.
CALIF• 460
from 07/01/2018
FORM
through 09/22/2018
Page 35 Of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
ZIPDE O
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
(EETAIF COMMITTEE, SAND
.D.N
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
OF REQUIRED)
OF BUSINESS)
08/15/2018
Carl Huber
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Carl HuberX❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.1520 Fifth Rafael.
❑ SCC
07/15/2018
Scott Ingels
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Scott Ingels
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Scott Ingels
x❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth v f 4
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA
to whole dollars.
I � '
"
from 07/01/2018
•
through 09/22/2018
Page 36 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
PER ELECTION
TO DATE
(E COMMITTEE, ALSO ENTER 1. D. NUMBER)
*
OCCUPATION AND EMPLOYER
CALENDAR YEAR
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Scott Ingels
MIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Rebecca Jensen
MIND
Call Taker & Records
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue, San Rafael. CA 94901
[-]SCC
07/31/2018
Rebecca Jensen
x❑IND
Call Taker & Records
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
[:]COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Rebecca Jensen
MIND
Call Taker & Records
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Rebecca Jensen
MIND
Call Taker & Records
12.70
203.20
c/o San Rafael Police Association 1520 Fifth
COM
Specialist
Avenue
❑
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 F'Avenue,
SUBTOTAL$ 67.10
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
towholedollars.
• I '
from 07/01/2018
• "
through 09/22/2018
page 37 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(E COMMITTEE ALSAND
.D. NUMBER)
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Rebecca Kuga
MIND
YSB Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Rebecca Kuga
MIND
YSB Supervisor
12-70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue, San
❑ SCC
08/15/2018
Rebecca Kuga
x❑IND
YSB Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Rebecca Kuga
MIND
YSB Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTy
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Marc Lap ante
91 IND
Ufficer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
ElSCC
SUBTOTAL$ 67.10
'Contributor Codes
IND— Individual
COM -- Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA ii
to whole dollars.I
,
from 07/01/2018
'
through 09/22/2018
page 38 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A ZIP
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, LD NUMBER)
IT
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Marc Laplante
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Marc Laplante[K]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.1520 Fifth
❑ SCC
08/31/2018
Marc Laplante
%❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Anndora Lee
x❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[-]Com
City of San Rafael
Avenue
San Rafael, CA 94901
[:]OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Ann ora LeeX❑IND
Dispatc e
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of Sran Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael, CA 949QJ—
❑ SCC
SUBTOTAL$ 74.30
`Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
to whole dollars.
from 07/01/2018
FZ-1—
through 09/22/2018
page 39
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, I.D. NUMBER)
IT
CODE *
OCCUPATION AND EMPLOYER
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Anndora Lee
x❑IND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Anndora Lee
MIND
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San Rafael, CA 94901
❑ SCC
07/15/2018
Karl Luhmann
x❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, an Rafael CA 94901
07/31/2018
Karl Luhmann
MIND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Kar Lu mann
MIND
Police officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
City Of San Rafael
❑ COM
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 74.30
`Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
0TH - Other (e.g., business entity)
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
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers periodCALIFORNIA
to whole dollars.
I '
from 07/01/2016
• "
through 09/22/2018
Page 40 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Karl Luhmann
x❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Kevin Macdougald[K]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1S20 Fifth Avenue. San
❑ SCC
07/31/2018
Kevin Macdougald
KIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Kevin Macdougald
X❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Kevin Mac ouga
[g]IND
officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
ElSCC
SUBTOTAL$ 81.50
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
I � '
from 07/01/2018
FORM
through 09/22/2016
Page 41 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE. ALSO ENTER I.D NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Carlos Maldonado
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Carlos Maldonado
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]Com
City of San Rafael
Avenue
San Rafael, CA 94901
[:10TH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue, San Rafael. CA 94901
❑ SCC
08/15/2018
Carlos Maldonado
]IND
Officer
16.30
260.60
C/o: San Rafael Police Association 1520 Fifth
[-]Com
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/31/2018
Carlos Maldonado
[g] IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
El COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 15/2018
Kait in Maley
[K]IND
Police Officer
16.30
221.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
❑ SCC
SUBTOTAL $ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers periodFPage
_
to whole dollars.
/ ,
from 07/01/2018
through 09/22/2018
42 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ADDRESSZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
SAND
(IF COMMITTEE, D NUMBER)
IT
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Kaitlin Maley
x❑IND
Police Officer
16.30
221.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Kaitlin Maley%❑IND
Police Officer
16.30
221.20
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue,1q20 Fifth
❑ SCC
08/31/2016
Kaitlin Maley
]IND
Police Officer
16.30
221.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael CA 94901
07/15/2018
Michael Mathis
X❑IND
Corporal
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 31/2018
Michael Mathis
x❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Fifth Avenue.
[:]SCC
SUBTOTAL $ 81.50
`Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
I '
from 07/01/2018
• "
through 09/22/2018
Page 43 of_ 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO .D NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
OF REQUIRED)
OF BUSINESS)
08/15/2018
Michael Mathis
MIND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Michael Mathis
MIND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]Com
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
P P
❑ SCC
07/15/2018
Kelly Mauel
x❑IND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Kelly Mauel
MIND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08715/2018
Ke y Maue
MINDCommunications
Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
El COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
ElSCC
1520 FifthAvenue.
SUBTOTAL$ 70.70
`Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
0TH - Other (e.g., business entity)
PTY - Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
page 44 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECDREODDTHIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
DATE
TOQUIR
RECEIVED
(IF COMMITTEE, ALSO ENTER I,D,NUMBER)
CODE *
O(I SELLF-EMPPLOYED, ECUPATION AND NTER NAME
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Kelly Mauel
x❑IND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
0 COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Phillip Melodia
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
❑ OTH
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1920 Fifth Avenue. San
❑ SCC
07/31/2018
Phillip Melodia
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]Com
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Phillip Melodia
El IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
[]OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08731/2018
Phillip Me o is
X❑IND
officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
[]SCC
SUBTOTAL$ 77.90
`Contributor Codes
IND—Individual
COM —Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
to whole dollars.from
OEM
07/01/2018
through 09/22/2018
Page 45 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Beth Minka
x❑IND
Administrative Technician
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Beth Minka
X❑IND
Administrative Technician
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.1920 Fifth
❑ SCC
08/15/2018
Beth Minka
x❑IND
Administrative Technician
12.70
203.20
C/O: San Rafael Police Association 1520 FifthEJ
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/31/2018
Beth Minka
X❑IND
Administrative Technician
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07715/2018
Cynthia Morgan
X❑IND
Call Taker and Records
12.70
203.20
C/o: San Rafael Police Association 1520 FifthSpecialist
[-]COM
Avenue
San Rafael, CA 94901
❑ OTH
City Of San Rafael
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue, 4
SUBTOTAL$ 63.50
'Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period I
CALIFORNIA
to whole dollars.
4601: � '
from 07/01/2018
• '
through 09/22/2018
page 46 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
DATE
TO
RECEIVED
(IF COMMITrEE,ALSO ENTER I.D.NUMBER)
CODE *
O(I FSELLFEMP OENTER RNOAMER
IOD
(JAN. 1 -OEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Cynthia Morgan
X❑IND
Call Taker and Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Cynthia Morgan
X❑IND
Call Taker and Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
08/31/2018
Cynthia Morgan
x❑IND
Call Taker and Records
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Specialist
Avenue
City Of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Lynn Murphy
❑IND
Mental Health Outreach
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Provider
Avenue
San Rafael, CA 94901
❑ OTH
City of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/2018
Lynn Murphy
X❑IND
Menta Hea t Outreach
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Provider
Avenue
San Rafael, CA 94901
❑ OTH
City of San Rafael
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. 4
SUBTOTAL$ 63.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
I � '
from 07/01/2016
• '
through 09/22/2018
Page 47 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
IT O ENTER I.D. NUMBER)
(IF COMMITTEE,
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1- DEC. 31)
OF REQUIRED)
OF BUSINESS)
08/15/2018
Lynn Murphy
X❑IND
Mental Health Outreach
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Provider
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Lynn Murphy
X❑IND
Mental Health Outreach
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
[-]COM
Provider
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.1q90 Fifth Rafael.
❑ SCC
07/15/2018
Jorge Navarro
x❑IND
Evidence Technician
12.70
203.20
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, an Rafael CA 94901
07/31/2018
Jorge Navarro
x❑IND
Evidence Technician
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
El COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Jorge Navarro
%❑IND
Evidence Technician
12.70
203.20
C/O: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
ElSCC
SUBTOTAL$ 63.50
'Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
I t
from 07/01/2018
through 09/22/2018
Page 48 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(E COMMITTEE. ALSENTERI.D.NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE*
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Jorge Navarro
x❑IND
Evidence Technician
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[:]SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Alexis Nielsen
RIND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
Rafael1q90 Fifth Avenue. San
❑ SCC
07/31/2018
Alexis Nielsen
BIND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Alexis Nielsen
]IND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
San Rafael, CA 94901
❑ OTH
City of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Alexis Nielsen
MIND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
Dispatcher
Avenue
❑ COM
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
[:]SCC
SUBTOTAL$ 63.50
"Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
from 07/01/2018
WON=
through 09/22/2018
Page 49 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
ZII.D.N DE -O
FULL NAME, STREET ADDRESS AND ZIP CODE- OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVETO DATE
PER ELECTION
DATE
(E COMMITTEE. ALSO ENTER
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Oscar O'con
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Oscar O'conx❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue, San Rafael. CA 94901
❑ SCC
08/15/2018
Oscar O'con
FT IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
06/31/2018
Oscar O'con
]IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07715/2018
Leslie O'Too e
X❑IND
0 icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 50 Of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
(E COMMITTEE. ALSENTERI.DNUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE*
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Leslie O'Toole
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Leslie O'Toole
KIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
Rafael.1S20 Fifth Avenue. San
❑ SCC
08/31/2018
Leslie O'Toole
[k]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[—]SCC
1520 Fifth Avenue an Rafael CA 94901
07/15/2018
Brian Patterson
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Brian Patterson
x❑IND
0 icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
2Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND— Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period I
CALIFORNIA
towholedollars.
I '
'
from 07/01/2018
•
through 09/22/2016
Page 51 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND ZIPDE O
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO .D.N
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Brian Patterson
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Brian Patterson
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
07/15/2018
Buffy Paxson
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]Com
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. an Rafael CA 94901
07/31/2018
Buffy Paxson
%❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Buffy Paxson
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
El SCC
1520 F'Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity;
PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
I '
from 07/01/2018
through 09/22/2018
page 52 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I D NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Buffy Paxson
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Jessica Perry
MIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
i�;qn T7ift-h Avenue. San Rafael. CA 94901
❑ SCC
07/31/2018
Jessica Perry
[91 IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Jessica Perry
MIND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
E] COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTI'
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Jessica Perry
MIND0
icer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ pT(
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
[-]SCC
SUBTOTAL$ 81-50
*Contributor Codes
IND- Individual
COM-- Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.neffile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period I
CALIFORNIA
to whole dollars.
I '
from 07/01/201e
• "
through 09/22/2018
Page 53 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
AND
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSO D NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Aaron Piombo
x❑IND
Police Corporal
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Aaron Piombo
X❑IND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
❑ OTH
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San P
❑ SCC
08/15/2018
Aaron Piombo
RIND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[-]COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Aaron Piombo
RIND
Police Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Dennis Prince
[K]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue,Rafael,
SUBTOTAL$ 131.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT)
Monetary Contributions Received Amounts may be rounded
statement covers period
to whole dollars.
I '
from 07/01/2018
• "
through 09/22/2018
page 54 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
ZIPDE O
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
IT 10- N
(IF COMMITTEE,
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN, 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Dennis Prince
%❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Dennis Prince
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1190 Fifth Avenue, San Rafael. CA 94901
❑ SCC
08/31/2018
Dennis Prince
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Gino Rantissi
x❑IND
Officer
16.30
260.80
c/o San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, San Rafael, CA 94901
07731/2018
Gino Rantissi
x❑IND
O icer
16.30
260.80
c/o San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
Avenue.1520 Fifth A 4
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
• _
towholedollars.
I '
from 07/01/2018
•
through 09/22/2018
Page 55 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERI.D.NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Gino Rantissi
x❑IND
Officer
16.30
260.80
c/o San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Gino RantissiX❑IND
Officer
16.30
260.80
c/o San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
❑ OTH
San Rafael, CA 94901
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Avenue.1520 Fifth
❑ SCC
07/15/2018
Ronda Reese
BIND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Ronda Reese
E] IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Ronda Reese
X❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue,
[:]SCC
SUBTOTAL$ 81.50
'Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018
Page 56 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERI.D NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Ronda Reese
x❑IND
Corporal
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Peggy RugeX❑IND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth❑
COM
Dispatcher
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue. San Rafael. CA 94901
❑ SCC
07/31/2018
Peggy Ruge
QIND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
City of San Rafael
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[]SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Peggy Ruge
x❑IND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
San Rafael, CA 94901
❑ OTH
City of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Peggy Ruge
X❑IND
Lead Communications
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
Dispatcher
Avenue
San Rafael, CA 94901
❑ OTH
City of San Rafael
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
ElSCC
Fifth Avenue.
SUBTOTAL$ 67.10
"Contributor Codes
IND— Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA
to whole dollars.
I � 1
from 07/01/2018
• '
through 09/22/2018
Page 57 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A ZIP
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
IT I.D. NUMBER)
(IF COMMITTEE,
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Travis Ruggles
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94974
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Travis Ruggles
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94974
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.
❑ SCC
08/15/2018
Travis Ruggles
x❑IND
Police Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94974
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael CA 94901
08/31/2018
Travis Ruggles
RIND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94974
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Thomas Sa i o
RIND
officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael,'CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, Rafael
SUBTOTAL$ 81.50
'Contributor Codes
IND—Individual
COM —Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
.
towholedollars.
I'
from 07/01/2018
�
through 09/22/2018
Page 58 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVETO DATE
PER ELECTION
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Thomas Sabido
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Thomas Sabido
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue, San
❑ SCC
08/31/2018
Thomas Sabido
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. an Rafael CA 94901
07/15/2018
Sebastian Sanchez
X❑IND
Police Officer
16.30
206.50
C/o: San Rafael Police Association 1520 Fifth
[:]COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Sebastian Sanchez
X❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 F'Avenue.
SUBTOTAL$ 81.50
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
to whole dollars.
I '
from 07/01/2018
�
through 09/22/2016
page 59 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Sebastian Sanchez
X❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth❑
COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Sebastian Sanchez
X❑IND
Police Officer
16.30
208.50
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.11;20 Pift-), Avenue. San
❑ SCC
07/15/2018
Anthony Scalercio
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
[-]SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Anthony Scalercio
QIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Anthony Scalercio
QIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received thrqugh
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 61.50
*Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
Il '
from 07/01/2018
• '
through 09/22/2018
Page 60 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D.NUMBER)
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Anthony Scalercio
x❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
George Schikore
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 FifthEl
COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
07/31/2018
George Schikore
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
E01 SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
George Schikore
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
George Schikore
[X]IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, 4
SUBTOTAL$ 81.50
*Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY- Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
I '
from 07!01/2018
through 09/22/2018
Page 61 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPDE O
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(E COMMITTEE, ALSOAENTERND
I.D.N
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED ENTER NAME
PERIOD
(JAN. 1 DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Justin Schraeder
X❑IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Justin Schraeder
]IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth
[-]Com
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1920 Fifth Avenue, San Rafael. CA 94901
[-]SCC
08/15/2018
Justin Schraeder
x❑IND
Officer
16.30
260.80
C/O: San Rafael Police Association 1520 Fifth❑
COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Justin Schraeder
RIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07 /15/2018
Wanda Spa etta
RIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
❑ COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue.
SUBTOTAL$ 81.50
'Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
to whole dollars.
'
ME
from 07/01/2018
through 09/22/2018
Page 62 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
A ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
RE ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(IF COMMITTEE. I D. NUMBER)
IT
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2016
Wanda Spaletta
X❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Wanda Spalettax❑IND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1520 Fifth Avenue. San
❑ SCC
08/31/2018
Wanda Spaletta
BIND
Sergeant
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Lynette Starnes
x❑IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
El SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/31/2018
Lynette Starnes
RIND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue. San Rafael. CA 949QI--
❑ SCC
SUBTOTAL$ 74.30
'Contributor Codes
IND -Individual
COM-- Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity;
PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
I t
from 07/01/2018
• '
through 09/22/2018
Page 63 of71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSENTERI.D.NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/15/2018
Lynette Starnes
X❑IND
Community Service Officer
12.70
203.20
C/O: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[:]PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Lynette Starnes
[K]IND
Community Service Officer
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,-ir9n Fifti, Avenue. San Rafael. CA 94goi
❑ SCC
07/15/2018
Remington Stobo
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94902
07/31/2018
Remington Stobo
X❑IND
Police Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/15/2018
Remington Stobo
X❑IND
Police officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
El SCC
Avenue,1520 Fifth 4
SUBTOTAL$ 74.30
`Contributor Codes
IND— Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY --Political Party
SCC—Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
statement covers period
CALIFORNIA
to whole dollars.
I � '
from 07/01/2016 -
FORM
through 09/22/2018
Page 64 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
ZIPO
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(E COMMITTEE, ALSAND
I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
08/31/2018
Remington Stobo
MIND
Police Officer
16-30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/15/2018
Charly Taylor
MIND
Civilian Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
OTH
San Rafael, CA 94901
❑
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael.1920 Fifth Avenue. San
[-]SCC
07/31/2018
Charly Taylor
x❑IND
Civilian Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue an Rafael CA 94901
08/15/2018
Charly Taylor
MIND
Civilian Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
08/31/2018
Charly Tay or
MINDCavi
ian Supervisor
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
City of San Rafael
Avenue
[-]COM
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue. A
SUBTOTAL$ 67-10
'Contributor Codes
IND -Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
• _
to whole dollars.
I '
from 07/01/2018
• '
through 09/22/2018page
65 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/15/2018
Saskia Van Buuren
X❑IND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
07/31/2018
Saskia Van Buuren
x❑IND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
[-]PTY
intermediary: San Rafael Police Association,
1-;9n Piftb Avenue, San Rafael. CA 94901
❑ SCC
08/15/2018
Saskia Van Buuren
RIND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
E] COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/31/2018
Saskia Van Buuren
RIND
Communications Dispatcher
12.70
203.20
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City Of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue, San Rafael, CA 94901
07/15/2018
Mark Wi inson
]IND
officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑ COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
1520 Fifth Avenue.
❑ SCC
SUBTOTAL$ 67.10
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC --Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.netfiie.com
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIF•
to whole dollars.
I '
from 07/01/2018
• �
through 09/22/2018
Page 66 of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
RES ZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A
CONTRIBUTOR
IF AN iNDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
SAND
IT I, D, NUMBER)
(IF COMMITTEE.
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED. ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
07/31/2018
Mark Wilkinson
)IND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑ SCC
1520 Fifth Avenue San Rafael CA 94901
08/15/2018
Mark Wilkinson
X❑IND
Officer
16.30
C/o: San Rafael Police Association 1520 Fifth
❑COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
Rafael,1520 Fifth Avenue. San
❑ SCC
08/31/2018
Mark Wilkinson
BIND
Officer
16.30
260.80
C/o: San Rafael Police Association 1520 Fifth
❑COM
City of San Rafael
Avenue
San Rafael, CA 94901
❑ OTH
Union member's dues received through
❑ PTY
intermediary: San Rafael Police Association,
❑SCC
1520 Fifth Avenue San Rafael CA 94901
❑IND
❑COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 48.90
'Contributor Codes
IND— Individual
COM —Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY—Political Party
SCC— Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
www.neffile.com
Schedule D
SCHEDULE D
Summary of Expenditures
Statement covers period
Supporting/OpposingOther Amounts may be rounded
dollars.
� . ,
"
to whole
from 07/01/2018
•
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
through 09/22/2018
Page 67 Of 71
NAME OF FILER
I.D. NUMBER
San Rafael Police Association Political Action Committee
831553
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
TYPE OF PAYMENT
DESCRIPTION
AMOUNT THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
MEASURE NUMBER OR LETTER AND JURISDICTION,
(IF REQUIRED)
PERIOD
(JAN 1 -DEC. 31)
(IF REQUIRED)
OR COMMITTEE
08/28/2018
Lori Frugoli
Monetary
500.00
500.00
District Attorney
Marin County, CA
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑x Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
SUBTOTAL $ 500.00
Schedule D Summary
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) .........
2. Unitemized contributions and independent expenditures made this period of under $100
$ 500.00
$ 0.00
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............. TOTAL $
500.00
WWW.neff/l@.Com FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E
Payments Made
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2018
[-0].1091911Ml
SEE INSTRUCTIONS ON REVERSE through 09/22/2018 Page 68 of 71
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.
CMP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID
Donor Stack, LLC WEB 146.35
5940 College Avenue, Suite F
Oakland, CA 94618
Donor Stack, LLC WEB 117.60
5940 College Avenue, Suite F
Oakland, CA 94618
Donor Stack, LLC WEB 88.11
5940 College Avenue, Suite F
Oakland, CA 94618
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 352.06
Schedule E Summary
1. Itemized payments made this period. Include all Schedule E subtotals. 1,595.86
2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0.00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................... $ 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 1,595.86
FPPC Form 460 (Jan/2016)
FPPCToll-Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule E
(Continuation Sheet)
Payments Made
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2018
through 09/22/2018
SCHEDULE E
Page 69 of 71
I.D. NUMBER
831553
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CNP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)`
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Donor Stack, LLC
WEB
86.30
5940 College Avenue, Suite F
Oakland, CA 94618
Lori Frugoli for Marin County District Attorney 2018 (ID# 1393994)
CTB
500.00
34 Taft Court
Novato, CA 94947
S.E. Owens & Company
PRO
216.50
5940 College Avenue Suite F
Oakland, CA 94618
S.E. Owens & Company
PRO
441.00
5940 College Avenue Suite F
Oakland, CA 94618
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,243.80
www.netfile.com
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2018
through 09/22/2018
SCHEDULEF
Page 70 of 71
I.D. NUMBER
831553
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FIND
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
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF CREDITOR
CODE OR
(
OUTSTAA NDING
(
AMOUNTIN CURRED
(c)
AMOUNT PAID
(
OUTSTANDING
(IF COMMITTEE, ALSO ENTER LD NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCE AT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
Donor Stack, LLC
WEB
146.35
0.00
146.35
0.00
5940 College Avenue, Suite F
Oakland, CA 94618
Payments that are contributions or independent expenditures must also be
summarized on Schedule D.
SUBTOTALS $ 146.35$ 0.00$ 146.35$ 0.00
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ..
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.).................................................................................................
www.netfile.com
.............................PAID TOTALS $
U.11O
146.35
............................................. NET $ -146.35
May be a negative number
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
Crhnrir rin I
SCHEDULE[
Miscellaneous Increases to Cash Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Statement covers periodCALIFORNIA
from 07/01/201.8
through 09/22/2018
,
� •
FORM
Page 71 of 71
NAME OF FILER
San Rafael Police Association Political Action Committee
I.D. NUMBER
831553
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF RECEIPT
AMOUNT OF
INCREASE TO CASH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule I Summary
1. Itemized increases to cash this period........................................................................................................................$
2. Unitemized increases to cash of under $100 this period............................................................................................. $
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
SummaryPage, Line 14.) ........................................................................................................................... TOTAL $
www.netfile.com
0_00
1.63
0_00
1.63
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov