Los Angeles Clippers

STATE OF CALIFORN IA DEPARTMENT OF JUSTICE BGC 203 PAGE 1 of4 (Rev. 10/2018) MAJOR LEAGUE SPORTS RAFFLE ELIGIBLE ORGANIZATION RAFFLE REPORT PLEASE SEND COMPLETED REPORT TO: Bureau of Gambling Control P. 0. Box 168024 Sacramento , CA 95816-8024 Phone: 916-830-1700 Raffle Report Period: +=---Se_a_so_n_o_r -=o=--c_al_en_d_a_r Y_e_ar_D_at__()=·es_:_0_;;\-o_ .....:;\J:.._~_? ...:.....__:,.\ ?-_.,._,,.~'-----'\:....;,_..,L.:..J.7_- ~-'.··_,_\I ) J 'd() I~

Eligible Organization's Name: Los AriC/jJ..e.s(A :,~.s 'f'olAN'l~l~OV\

Eligible Organization's Registration Number: Pursuant to Penal Code section 320.6, subdivision (o)(13)(A) , once registered, an eligible organization shall file with the Department of Justice, each season or year thereafter, a report that includes all of the following information. Pursuant to Penal Code section 320.6, subdivision (0)(13)(8), failure to submit the seasonal or annual report shall be grounds for denial of an annual registration and for the imposition of penalties under Government Code section 12591.1.

SECTION 1: SEASON OR ANNUAL RAFFLE TOTALS

Total number of raffles conducted for the The gross receipts generated from the sale of season or calendar year. lf3 raffle tickets for the season or calendar year. 11Ljd1)} O L/S- The average per raffle gross receipts The prize total for the season or calendar year , generated from the sale of raffle tickets for 11 $;>---10;0 .l) )·1w including any prize that was not claimed. the season or calendar year. c;

The average per-raffle prize total for the The prize total that was not claimed, if any, during season or calendar year, including any prize ILj J ~~Lf the season or calendar year. ~3?Jcr33 that was not claimed.

For each raffle in which the raffle prize was not claimed, list the name of the eligible recipient organization that received the prize (attach additional sheets , if needed).

Lo~ AvlfA. e,;\ e..s c_:x:\ Q{l CK"S Y::.o~~vV\ u IJ\) STATE OF CALIFORNIA DEPARTMENT OF JUSTICE BGC203 PAGE2of4 (Rev. 10/2018) MAJOR LEAGUE SPORTS RAFFLE ELIGIBLE ORGANIZATION RAFFLE REPORT

SEGTION 2: COST RELATEE> INFORMATION

Provide a total of the direct costs of conducting the raffles for:

Labor Consulting Software Marketing Raffle Equipment 10 10 ~30)1]3, 1~ ,?"~3b.01 tYg.:7,b,'S. b-3

Provide a schedule of vendors used to operate the raffles and total payments made to each vendor. Attach additional sheets if needed.) Amount Paid 5050 ~w-w-\ ·17e.Aawcvr..(L~c. , i .;ti . oqI , -;~ ~vVVVIO vJov\dw~(L ~r '# /c:J,500. oo u SCJ·.A r.v/ e_ 4 \. S"SI. ~ h n )( \ \ lA. Y\a,,y- \t, ~ V\~ Q~3b. o9 u \)CV<,7 nY1 -J'~s,b~7. '6~ G_\ ,., ....-\~ ~~ "'-- bY'eD./h\{)I)...~ # I I b I b. iC../ 0 STATE OF CALIFORNIA DEPARTMENTOF JUSTICE BGC203 PAGE 3 of4 (Rev. 1012018) MAJOR LEAGUE SPORTS RAFFLE ELIGIBLE ORGANIZATION RAFFLE REPORT

SECTION 3: FOR EACH RAFFLE EVENT PLEASE PROVIDE THE FOLLOWING INFORMATION (attach additional sheets_.if needed)

Gross Receipts Amount Each Prize Status Registered Benefitting Organization (Eligible Organization or Eligible Generated by Winning Ticket Event Date Organization (Claimed/ Event ID# Recipient Organization) the Sale of Number Received Unclaimed) Raffle Tickets 5e,p_ CA.:k\-~ e,\,,..ec\

CERTIFICATION

I declare under penalty of perjury under the laws of the State of California that the foregoing information is true, correct, and complete. First Name Last Name Middle Initial

Fiduciary's Printed Name 1) e,M\S-e_ ~o o~ A Fiduciary's Signature: ~~-~;a---~--.------0-at-e:-- \ -\ _) _,g_/_l_q_ ~ 7 i Gross Receipts Amount Each Generated by the Sale Organization Winning Ticket Registered Event ID# Event Date Benefitting Organization of Raffle Tickets Received Number Prize Status 170000298 10/12/2017 Los Angeles Clippers Foundation $ 3,430 $ 1,715 A-557367 Claimed 170000308 10/13/2017 Los Angeles Clippers Foundation $ 4,410 $ 2,205 B-545574 Unclaimed 170000318 10/21/2017 Los Angeles Clippers Foundation $ 6,610 $ 3,305 C-502542 Claimed 170000328 10/24/2017 Los Angeles Clippers Foundation $ 3,555 $ 1,777 D-441924 Claimed 170000338 10/28/2017 Los Angeles Clippers Foundation $ 4,590 $ 2,295 E-292545 Unclaimed 170000348 10/30/2017 Los Angeles Clippers Foundation $ 9,510 $ 4,755 F-183523 Claimed 170000358 11/1/2017 Los Angeles Clippers Foundation $ 3, 875 $ 1,937 G-259191 Claimed 170000368 11/4/2017 Los Angeles Clippers Foundation $ 5,750 $ 2,875 H-284338 Claimed 170000378 11/5/2017 Los Angeles Clippers Foundation $ 9,915 $ 4,957 1-257500 Claimed 170000388 11/13/2017 Los Angeles Clippers Foundation $ 10,645 $ 5,322 J-262529 Claimed 170000398 11/27/2017 Los Angeles Clippers Foundation $ 14,000 $ 7,000 K-461778 Claimed 170000408 11/30/2017 Los Angeles Clippers Foundation $ 7,710 $ 3,855 L-527690 Unclaimed 170000418 12/6/2017 Los Angeles Clippers Foundation $ 7,015 $ 3,507 M-146941 Claimed 170000428 12/9/2017 Los Angeles Clippers Foundation $ 9,855 $ 4,927 N-283916 Claimed 170000438 12/11/2017 Los Angeles Clippers Foundation $ 9,980 $ 4,990 0-556978 Claimed 170000448 12/20/2017 Los Angeles Clippers Foundation $ 8,890 $ 4,445 P-284314 Claimed 170000458 12/26/2017 Los Angeles Clippers Foundation $ 9,295 $ 4,647 Q-489929 Claimed 170000468 12/31 / 2017 Los Angeles Clippers Foundation $ 9,240 $ 4,620 R-250760 Claimed 180000012 1/2/2018 Los Angeles Clippers Foundation $ 10,480 $ 5,240 S-279327 Claimed 180000022 1/4/2018 Los Angeles Clippers Foundation $ 13,235 $ 6,617 T-167435 Claimed 180000032 1/6/2018 Los Angeles Clippers Foundation $ 17,405 $ 8,702 U-570999 Claimed 180000042 1/8/2018 Los Angeles Clippers Foundation $ 9,285 $ 4,642 V-216293 Claimed 180000052 1/13/2018 Los Angeles Clippers Foundation $ 10,225 $ 5,112 W-407342 Claimed 180000062 1/15/2018 Los Angeles Clippers Foundation $ 14,280 $ 7,140 X-334607 Claimed 180000072 1/17/2018 Los Angeles Clippers Foundation $ 9,460 $ 4,730 V-227283 Claimed 180000082 1/22/2018 Los Angeles Clippers Foundation $ 11,670 $ 5,835 Z-359556 Claimed 180000092 1/24/2018 Los Angeles Clippers Foundation $ 14,265 $ 7,132 A-535120 Unclaimed 180000102 1/30/2018 Los Angeles Clippers Foundation $ 9,800 $ 4,900 B-324755 Claimed 180000112 2/3/2018 Los Angeles Clippers Foundation $ 10,705 $ 5,352 C-445493 Claimed 180000122 2/5/2018 Los Angeles Clippers Foundation $ 7,755 $ 3,877 D-242270 Unclaimed 180000132 2/28/2018 Los Angeles Clippers Foundation $ 10,525 $ 5,262 E-364318 Claimed 180000142 3/2/2018 Los Angeles Clippers Foundation $ 11,130 $ 5,565 F-181801 Unclaimed 180000152 3/4/2018 Los Angeles Clippers Foundation $ 11,910 $ 5,955 G-507019 Unclaimed 180000162 3/6/2018 Los Angeles Clippers Foundation $ 8,330 $ 4,165 H-360603 Claimed 180000172 3/9/2018 Los Angeles Clippers Foundation $ 16,200 $ 8,100 1-148785 Claimed 180000182 3/10/2018 Los Angeles Clippers Foundation $ 13,595 $ 6,797 J-135512 Claimed 180000192 3/18/2018 Los Angeles Clippers Foundation $ 9,730 $ 4,865 K-377022 Claimed 180000202 3/27/2018 Los Angeles Clippers Foundation $ 8,995 $ 4,496 L-207835 Claimed 180000212 4/ 1/2018 Los Angeles Clippers Foundation $ 7,815 $ 3,907 M-389282 Claimed 180000222 4/3/2018 Los Angeles Clippers Foundation $ 11,855 $ 5,926 N-118558 Unclaimed 180000232 4/7/2018 Los Angeles Clippers Foundation $ 11,700 $ 5,850 0-547826 Claimed 180000242 4/9/2018 Los Angeles Clippers Foundation $ 7,100 $ 3,550 P-107235 Claimed 180000252 4/ 11/2018 Los Angeles Clippers Foundation $ 14,320 $ 7,160 Q-441011 Claimed

$ 420,045 $ 210,011 STATE OF CALIFORNIA DEPARTMENT OF JUSTICE BGC203 PAGE4of4 (Rev. 10/2018) MAJOR LEAGUE SPORTS RAFFLE ELIGIBLE ORGANIZATION RAFFLE REPORT

Privacy Notice on Data Collection Forms As Required by Civil Code § 1798.17

Collection and Use of Personal Information The Division of Law Enforcement, Bureau of Gambling Control in the Department of Justice collects the information requested on this form as authorized by California Penal Code section 320.6. The Bureau uses this information to establish grounds for the license, permit or other approval indicated on this application form. In addition, any personal information collected by state agencies is subject to the limitations in the Information Practices Act and state policy. The Department of Justice's general privacy policy is available at http://oag. ca.gov/privacy-po Iicy .

Providing Personal Information All the personal information requested in this form must be provided.

Access to Your Information You may review the records maintained by the Division of Law Enforcement, Bureau of Gambling Control in the Department of Justice that contain your personal information as permitted by the Information Practices Act. (See below for contact information.)

Possible Disclosure of Personal Information In order to process your application, we may need to share the information you give us with law enforcement or regulatory agencies.

The information you provide may also be disclosed in the following circumstances :

With other persons or agencies where necessary to perform their legal duties, and their use of your information is compatible and complies with state law, such has for investigations or for licensing, certification, or regulatory purposes;

To another government agency as required by state or federal law.

Contact Information For questions about this notice or access to you r records, you may contact the Special Agent Supervisor of Special Programs at the Department of Justice, Bureau of Gambling Control, at P. 0. Box 168024, Sacramento, CA 95816-8024, (916) 830-1700 or e-mail at GamblingControl@doj .ca.gov