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Home My WebLink AboutForm 460 - Samantha Ramirez for Board of Education Trustee 2020 (06-30-2022)Recipient Committee Campaign Statement Cover Page Statement covers period from January 1, 2022 SEE INSTRUCTIONS ON REVERSE I through June 30, 2022 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Parte) 0 Sponsored STATE (Also Complete Part 6) ❑ General Purpose Committee San Rafael 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Parry/Central Committee (Also Complete Parl7) 3. Committee Information I I.D. NUMBER NO COMMITTEE) Samantha Ramirez for San Rafael City Schools 2020 STREET ADDRESS (NO P.O. BOX) Preelection Statement ® Semi-annual Statement Termination Statement (Also file a Form 410 Termination) CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94903 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 OPTIONAL: FAX/E-MAIL ADDRESS 4. Verification I Date of election if applidable (Month, Day, Year [- — 2. Type of Statement: COVER PAGE ILERK'S JG - 1 2022 j� Page 1 of 3 OFFICEFor Official Use Only ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report 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-MAILADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of pedury under the laws of the State of California that the foregoing is Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent I 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 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Samantha Ramirez OFFICE SOUGHT OR HELD (INCLUDE LOCATIONAND DISTRICT NUMBER IFAPPLICABLE) San Rafael City School Board, Trustee Area 1 RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael CA 94903 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 LD NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO STREETAL)DRESS (NO P.U. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 3 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 Listnames 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 ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period from January 1, 2022 SUMMARY PAGE _ I June 30, 2022 I Page 3 of 3 NAME OF FILERI.D. NUMBER Samantha Ramirez 1430980 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line $ $ 1/1 through 6130 7/1 to Date 2. Loans Received............................................................... Schedule e, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS- ............................ AddLines1+2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED...............................Add Lines 3+4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made..... ...................... . ................. ....... ....... . Schedule E, Line 4 $ $ Candidates 7. Loans Made.. -... .. . ........ ........... ....... .............................. Schedule H, Line 3 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .....................:................. Add Lines s+7 $ $ (if Subject to VoluntaryExpendltureLlmlt) 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+9+10 $ $ 1 $ Current Cash Statement 12. Beginning Cash Balance ...... ...................... Previous Summary Page, Line 16 $ 41653 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 $ 41653 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule S, Parte $ 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). —J_ J. $ "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