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Form 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)