HomeMy WebLinkAboutForm 460- Lucia Martel Dow for San Rafael School Board 2022; 06-30-22Recipient CommitteeCOVER
Campaign Statement
I I.D. NUMBER
D
Treasurer(s)
PAGE
e a�, [ '_ • 1
'
Cover Page
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
(Government Code Sections 84200-84216.5)
Lucia Martel Dow for San Rafael School Board 2022
Lucia Martel Dow
Statement covers period
Date of election if app!fll !
AUG -
1 2022 1 of e
�zz
(Month, Day, Year
g e
from _
AREA CODE/PHONE
Executed on
By
Date
Signature of ConlroNing Officeholder, Candidate, Siete Measure Proponent
Executed on By
Date Signature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Lucia Martel Dow
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
School Board City of San Rafael
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Novato CA 94949-5731
Related Committees Not Included in this Statement: List any committees
not included in this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEENAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page 2 of 8
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ 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
j_❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
Campaign Disclosure Statement SUMMARYPAGE
Amounts may be rounded Statement covers period
Summary Page to whole dollars. . 1
from 01/01/2022 • -
SEE INSTRUCTIONS ON REVERSE through 06/30/2022 Page 3 of 8
NAME OF FILER I.D. NUMBER
Lucia Martel Dow for San Rafael School Board 2022 1442869
Expenditures Made
Column A
6. Payments Made............... ........................................
Column B
Calendar Year Summary for Candidates
Contributions Received
7. Loans Made .............................................................
Saheimus3
TOTALTHISPERIOD
0.00
CALENDARYEAR
g Primary
Running in Both the State Prima and
$
498.91
9. Accrued Expenses (Unpaid Bills ...........scIM1111111IF:;W3
(FROM ATTACHED SCHEDULES)
TOTALTO DATE
10. Nonmonetary Adjustment ..........................................
schaNC'W3
0.00
11. TOTAL EXPENDITURES MADE ................................
Add tA11104-10
General Elections
1. Monetary Contributions .........................................
Sc~ - -in 3
$
1,150.00
$
1,150.00
1/1 through 6/30 7/1 to Date
2. Loans Received......................................................
Sohe"UW 3
0.00
0.00
3. SUBTOTALCASH CONTRIBUTIONS .........................
AM= 1*2
$
1,150.00
$
1,150.00
20. Contributions
Received $ $
4. Nonmonetary Contributions-,-...... ...........................
Schemc-03
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED••••••..................•••Aditw3+4
$
1,150.00
$
1,150.00
Made $ $
Expenditures Made
6. Payments Made............... ........................................
SchesELM4
$
498.91
7. Loans Made .............................................................
Saheimus3
0.00
8. SUBTOTAL CASH PAYMENTS ....................................
AdMm6+7
$
498.91
9. Accrued Expenses (Unpaid Bills ...........scIM1111111IF:;W3
236.48
10. Nonmonetary Adjustment ..........................................
schaNC'W3
0.00
11. TOTAL EXPENDITURES MADE ................................
Add tA11104-10
$
735.39
Current Cash Statement
12. Beginning Cash Balance ....................... PrevioussummarypecMIG $
13. Cash Receipts ................................................... Column Al.ri�e
14. Miscellaneous Increases to Cash ........................... Schest:w4
15. Cash Payments .................................................. Column AAwsowe
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then suis a 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED
Schelfl .%t2 $
0.00
1,150.00
0.00
498.91
651.09
0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ see instracUsanstmone $ 0.00
19. Outstanding Debts ......................... Add Line 2+Line 9inGlamd3nove $ 1,170.39
$ 498.91
0.00
$ 498.91
1,170.39
0.00
$ 1,669.30
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).
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)
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275.3772)
Crhnr1i iIn A
SCHEDULE A
Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers period
e - . ,
from 01/01/2022
FORM
through 06/30/2022
Page 4 of8
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Lucia Martel Dow for San Rafael School Board 2022
1442869
��
ZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
A RE
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
ALSAND
IT I.D. NUMBER)
(IF COMMITTEE
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
01/28/2022
Alexandra Cremades
MIND
Director New Product
100.00
100.00
G2022 $100.00
❑COM
Development
San Rafael, CA 94903
❑OTH
Treasury Wine Estates
❑ PTY
❑ SCC
01/10/2022
Gina Daly
MIND
Higher Education Advocate
250.00
250.00
G2022 $250.00
❑COM
UC Berkeley
San Rafael, CA 94903
❑OTH
❑ PTY
❑ SCC
01/31/2022
Giovanna Limongi
MIND
Director
100.00
100.00
G2022 $100.00
❑COM
SI School
San Francisco, CA 94118
❑OTH
❑ PTY
❑ SCC
02/02/2022
Jessica Marker
MIND
Social Services Management
100.00
100.00
G2022 $100.00
❑COM
Canal Alliance
San Rafael, CA 94901
❑ OTH
❑ PTY
❑SCC
01/09/2022
Maritza Martel
❑x IND
Physician
200.00
200.00
G2022 200.D0
❑COM
Providence Health and
Portland, OR 97229
Services
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 750.00 1
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.)...................................................................................... 1,050.00
2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 100.00
3. Total monetary contributions received this period.
Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1. ....... TOTAL $ 1,150.00
"Contributor 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/2076)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
Schedule A (Continuation Sheet)
SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
e
to whole dollars.
i
from 01/01/2022
'
through 06/30/2022
page 5 of 8
VAME OF FILER
I.D. NUMBER
Lucia Martel Dow for San Rafael School Board 2022
1442869
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 ENTERI.D.NUMBER)
CODE
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
01/10/2022
Christian Orta
FK] IND
Product Manager
100.00
100.00
G2022 $10U.00
❑COM
Remitly Inc
San Rafael, CA 94901
❑ OTH
❑ PTY
❑ SCC
01/12/2022
Natalie Smith
x❑IND
Recruiter
100.00
100.00
G2022 $100.00
❑COM
Unity Technologies
San Rafael, CA 94903
❑ OTH
❑ PTY
❑ SCC
01/13/2022
Allison Uppendahl
RIND
Nurse
100.00
100.00
G2022 $100.00
❑COM
Kaiser
San Rafael, CA 94903
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
[]OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 300.00
*Contributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY— Political Party
SCC — Small Contributor Committee
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Lucia Martel Dow for San Rafael School Board 2022
Amounts may be rounded
to whole dollars.
Statement covers period
from 01/01/2022
through 06/30/2022 Page 6 of 8
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
1442869
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
TE1
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
Lrr
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)
wepac LLC
Novato, CA 94949
CODE OR
PRO/OFC
DESCRIPTION OF PAYMENT
AMOUNT PAID
449.91
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 449.91
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)...................................................................
2. Unitemized payments made this period of under $100...............................................................................................
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ....................................
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
................................1...111. $
449.91
$ 49.00
$ 0.00
................ TOTAL $
498.91
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
SCHEDULEF
Schedule F Amounts may be rounded Statement covers period CALIFORNIA
Accrued Expenses (Unpaid Bills) to whole dollars. from 01/01/2022 FORM 460
through 06/30/2022 Page 7 of 8
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER
Lucia Martel Dow for San Rafael School Board 2022 1442869
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
F1L
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)
* Payments that are contributions or independent expenditures must also be SUBTOTALS $ 933.91$ 6.9.75$ 449.91$ 553.75
summarized on Schedule D.
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.) .................................
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.)...........................................................................................................
INCURRED TOTALS $
PAID TOTALS $
686.39
449.91
.... NET $ 236.48
May be s ragatem rumW
FPPC Form 460 (Jan/2016)
(b)
(c)
(d)
NAME AND ADDRESS OF CREDITOR
CODE OR(a)
OUTSTANDING
AMOUNTINCURRED
AMOUNTPAID
OUTSTANDING
(IF COMMITTEE, ALSO ENTER I D. NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCE AT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
wepac LLC
PRO/OFC
449.91
0.00
449.91
0.00
Novato, CA 94949
wepac LLC
PRO/OFC
484.00
0.00
0.00
484.00
Novato, CA 94949
wepac LLC
PRO
0.00
69.75
0.00
69.75
Novato, CA 94949
* Payments that are contributions or independent expenditures must also be SUBTOTALS $ 933.91$ 6.9.75$ 449.91$ 553.75
summarized on Schedule D.
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.) .................................
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.)...........................................................................................................
INCURRED TOTALS $
PAID TOTALS $
686.39
449.91
.... NET $ 236.48
May be s ragatem rumW
FPPC Form 460 (Jan/2016)
Schedule F SCHEDULEF(CONT.)
(Continuation Sheet) Amounts may be rounded Statement covers period •
to whole dollars. • _ •
Accrued Expenses (Unpaid Bills) from 01/01/2022
through 06./3012022 Page 8 of a
NAME OF FILER I.D. NUMBER
Lucia Martel Dow for San Rafael School Board 2022 1442869
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
Lrr
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF CREDITOR
CODE OR
OUTS(NDING
(
AMOUNTIN CURRED
(c)
AMOUNT PAID
OUTSTANDING
(TAA
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCEAT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
wepac LLC
PRO
0.00
415.89
0.00
415.89
Novato, CA 94949
wepac LLC
PRO
0.00
200.75
0.00
200.75
Novato, CA 94949
SUBTOTALS $ 0.00$ 616.64$ 0.00 $ 616.64
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)