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Home My WebLink AboutForm 460 - Samantha Ramirez for Board of Education Trustee 2020; TerminationRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from July 1st, 2023 through September 6, 2023 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall (o) Controlled (Also Coir.Wo Part 5) Sponsored (Also Complex Pad 5) ❑ eneral Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMI Samantha Ramirez For San Rafael City Schools STREET ADDRESS (NO P.O. BOX) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1430980 CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 OPTIONAL: FAX / E-MAIL ADDRESS COVER PAGE � � v � � 1 Date of ele I pplicable: — 2 2'24 Page 1 of 3 (Mont , ay, ear) For Ofiiciel Use Onty K'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report m Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Samantha Ramirez MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement cror o ponsor Executed on By a;�a Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling OlAceholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period • . from January 1, 2023 • 6 ' SEE INSTRUCTIONS ON REVERSE through June 30, 2023 Page 2 of 3 NAME OF FILER I.D. NUMBER Samantha Ramirez 1430980 Contributions Received ToColu st E oD TALT(FROM B Calendar Year Summary for Candidates ATTACHED SCHEDULES) cColumn TOTAL TO DATE Running In Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ schedule B, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................... .Addunes3+4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ schedule E, Line 4 $ 212 $ Candidates 7. Loans Made....................................................................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ $ 22. Cumulative Expenditures Made" ....................................... (If Subject to voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+g+10 $ $ $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 216.53 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line s above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 If this Is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule a, 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 $ 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). I 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 (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Samantha Ramirez Amounts may be rounded to whole dollars. Statement covers period from July 1, 2023 through Sevtember 6, 2023 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E ;ALIFURNIA 4(�(� FORM �J{,/ I.D. NUMBER 1430980 CMP campaign paraphemalla/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 CODE OR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Secretary of State Sacramento, CA 95814 The UPS store #2623 POS San Rafael, CA DESCRIPTION OF PAYMENT Annual fee and penalty Shipping of check to secretary of state AMOUNT PAID 200.00 12 ` Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 212 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.)........................... $ 212 $ ............ $ — TOTAL $ 21212 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov