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Form 460 - Carolina Martin for San Rafael School Board Trustee 2022 09-29-22LU Q a O U CV CV 0 CNJ rn N CZ w CO 35 O N co E5m U A -0 a) + a 0 y V_/ m (L aci E E>� d:v0>0 w'VUc U_ LL- LL- C) L.LLC) C/) Sc - LO m C � o a E a6 O a] LL C N U E m m m m Q Ln C T O E (D N m m E a a cY U) U) W MINIM LLI N N O N d N \ m O 01 0 w c o J U N N -O N m- U E n E C) CL LL Do m -6 `m 75 f O o a 0 ¢ ca Eo o N 'r U -CO CO [a U FD C5 C+ i = a] =o c E o - E � -(0 � a� a � m O El E a) W LL U) m U) LL N i+ C N0 NU) , O m m O _ O C O O E m0 m L6 C `_ O a) E N aci E P (D CL a� �— o_ u) e Q H ❑k ❑ ❑ ❑ N N d 3 U) R a) w o W F3 K H � LL 41 C) Lu z U a) Q N N N L O y N 1 O O \ c O N E co O w N N O N d N \ m O 01 0 w V C M M N m a E � O O m o0 � � 0 CL LL a) O m O O `m 0 m E 0 E E U o 0- C) N N -O N m- U E n E C) CL LL Do m -6 `m 75 f O o a 0 ¢ LU W [� z w o li o N 'r U -CO CO [a U L 7 m m m In C C m O a) E o w a) m N .8 m m w m� c c 3 `o �U -0,6 c m m O] s C (q a) 0- w 2N a O N N N C 3 O N 22 A O N- m N N m N m m \ ❑ \ o ❑ ❑ u a) m m C L N N m m U 'O a) c 7 C 7 O No m o o 0 o 0 o 0 O - Oa a v 'o O m w m W p N U U U U v i n w w w w a) L Recipient Committee Campaign Statement Cover Page— Part 2 COVER PAGE - PART 2 • _ • - 460 Page 2 of 31 5. Officeholder or Candidate Controlled Committee - 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Carolina Martin OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT Board of Education City of San Rafael District 4 ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP OFFICE SOUGHT OR HELD ❑ SUPPORT Identify the controlling officeholder, candidate, or state measure proponent, if any. San Rafael CA 94901 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER 7. Primarily Formed Candidate/Officeholder Committee List names of NAME OF TREASURER CONTROLLED COMMITTEE? officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) 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 CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Campaign Disclosure Statement SUMMARY PAGE Amounts may be rounded Statement covers period � Summa Pae - g to whole dollars. from 01/01/2022 SEE INSTRUCTIONS ON REVERSE Schedule E, Line 4 $ 9,380.78 $ 9,380.78 through 09/24/2022 Page 3 of 31 NAME OF FILER 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9,380.78 $ 9,380.78 I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 161.44 161.44 10. Nonmonetary Adjustment .......................................... 1449397 Contributions Received 0.00 Column A Column B Calendar Year Summary for Candidates 9,542.22 TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 25, 064.00 $ 25, 064.00 2. Loans Received...................................................... Schedule B, Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 25, 064.00 $ 25, 064.00 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 25,064.00 $ 25,064.00 Made $ $ -- -I- - - - -- - - --- -- -------- 6. Payments Made ....................................................... Schedule E, Line 4 $ 9,380.78 $ 9,380.78 7. Loans Made............................................................. Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9,380.78 $ 9,380.78 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 161.44 161.44 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 9,542.22 $ 9,542.22 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 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 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, 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 $ www.netfile.com 0.00 To calculate Column B, add 25,064.00 amounts in Column A to the corresponding amounts from Column B of your last 0.00 9,380.78 report. Some amounts in Column A may be negative 15,683.22 figures that should be subtracted from previous period amounts. If this is the first report being filed 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 161.44 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) www.fppc.ca.gov Schedule SCHEDULE A Amounts may ne rounded Monetary Contributions Received to dollars.CALIFORNIA Statement covers period whole 460 from 01/01/2022 • - through 09/24/2022 Page 4 of 31 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/15/2022 Suedy Alfaro MIND Attorney 200.00 200.00 G2022 $200.00 F-1 COM County of San Diego Sari Diego, CA 92130 Received through intermediary: OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 C El SCC Arlington, VA 22204 08/25/2022 Iosefa Alofaituli RX Nonprofit Exec 150.00 150.00 G2022 $150.00 ❑ COM CI ELO Los Angeles, CA 90032 E] OTH Received through inter ediary: Donorbox ❑ P'T'Y 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/19/2022 Virginia Aubry ❑X IND Landscape Supervisor 100.00 100.00 G2022 $100.00 ❑COM City and County of San Sari Rafael, CA 94903 OTH Francisco Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/16/2022 Janet Auer x❑IND Not Employed 100.00 100.00 G2022 $100.00 ❑COM n/a Martinez, CA 94553 Received through inter ediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/22/2022 Amy Baer RIND Assistant Superintendent 100.00 100.00 G2022 $100.00 ❑ COMSan Rafael City Schools San Rafael, CA 94901 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 650.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)........................................................................................................ $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ www.netfile.com 23,915.00 1,149.00 25,064.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) RAA M AAA Y` i /w _ A -A-E. 1_. .Z. M - .I SCHEDULE A (CONT.) 1V1UI 1WLd1_VUF LlF1 JUt1Uf1S KeCe1VeQ Amounts may oe rounaea Statement covers period to whole dollars. � • 460 from ol/01/2022 • page 5 of 31 I.D. NUMBER through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 100.00 08/24/2022 Teveia Barnes RIND Not Employed 100.00 G2022 $100.00 n/a Belvedere Tiburon, CA 94920 ❑COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #-27 El SCC Arlington, VA 22204 1,000.00 G2022 $1,000.00 07/18/2022 Robert Benavidez RIND Chief Finance Officer 1,000.00 El COM United Way Bay Area Rancho Mirage, CA 92270 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 09/22/2022 Sara Bender x❑IND Spanish Teacher 100.00 100.00 G2022 $100.00 El COM Marin Primary & Middle San Rafael, CA 94901 ❑ OTH School Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, # 27 ❑ SCC Arlington, VA 22204 09/01/2022 Christopher Berini x❑IND Executive 100.00 100.00 G2022 $100.00 ❑ COM United Way Bay Area San Francisco, CA 94107 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ��--++C El SI.r Arlington, VA 22204 08/19/2022 Charles D Best 91 IND Founder 100.00 100.00 G2022 $100.00 DonorsChoose New York, NY 10018 F-1 COM OTH Received through inte mediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 1,400.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460, from 01/01/2022 FORM through 09/24/2022 Page 6 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 08/25/2022 Piper Bowman [R] IND Not Employed 250.00 250.00 G2022 $250.00 ❑COM n/a Sari Rafael, CA 94901 Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/22/2022 Walt Buster Z] IND Not Employed 100.00 100.00 G2022 $100.00 ❑ COM n/a San Rafael, CA 94 901 OTH Received through inte mediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/18/2022 Catherine Cafaro x❑IND Executive Assistant 250.00 250.00 G2022 $250.00 ❑COM CamelBak Petaluma, CA 94954 Received through intermediary: ❑ OTH Donorbox ❑PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 08/20/2022 Laura Cashion x❑IND Director of Finance 150.00 150.00 G2022 $150.00 ❑ COM Students Rising Above Sari Francisco, CA 94110 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 08/01/2022 Sarah Cason x❑IND Not Employed 275.00 275.00 G2022 $275.00 ❑COM n/a Sari rafael, CA 94901 Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 1,025.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) R11 r SCHEDULE A (CONT.) one ar ontribU lu"b Received iAniounts may De rounaea y Statement covers period to whole dollars. � • 460 from 01/01/2022 • Page 7 of 31 through 09/24/2022 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 250.00 250.00 08/25/2022 Kushal Chakrabarti x❑IND Executive G2022 $250.00 Opendoor San Anselmo, CA 94901 ❑COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 100.00 100.00 08/20/2022 Elisabeth Charles x❑IND Not Employed G2022 $100.00 COM n/a Kentfield, CA 94904 El ❑ OTH Received through inte mediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 r] SCC Arlington, VA 22204 08/31/2022 Kate Colin x❑IND Mayor 500.00 500.00 G2022 $500.00 City of San Rafael San Rafael, CA 94901 ❑COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 100.00 100.00 08/17/2022 Amy Conger x❑IND Education G2022 $100.00 Hamlin School Larkspur, CA 94939 ❑ COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #,27 El SCC Arlington, VA 22204 150.00 150.00 09/24/2022 Dawn Connolly x❑IND Paralegal G2022 $150.00 Lerner Poole & Stewart San Rafael, CA 94903 ❑COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 *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 www.netfile.com SUBTOTAL $ 1,100.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. I � 1 from 01/01/2022 • ' through 09/24/2022 Page 8 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 08/20/2022 Laura Coxx❑IND Not Employed 500.00 500.00 G2022 $500.00 El n/a Corte Madera, CA 94925 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 El SCC 08/25/2022 Ann Cummings 91IND Consultant 100.00 100.00 G2022 $100.00 ❑ COM Ann Cummings Corte Madera, CA 94925 OTH Received through intermediary: F] Donorbox ❑ PTY 2615 Columbia Pike, #,'t27 Arlington, VA 22204 ❑ SCC 08/01/2022 Gina Daly Rx Higher Education Advocate 250.00 250.00 G2022 $250.00 ❑ COM UC Berkeley San Rafael, CA 94903 Received through intermediary: ❑ OTH Donorbox F] PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑SCC 08/02/2022 Kathleen DeLaski x❑IND Not Employed 250.00 250.00 G2022 $250.00 ❑ COM n/a McLean, VA 22101 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/22/2022 Eve Dellinger x❑IND Staffing Partner & 250.00 250.00 G2022 $250.00 Consultant Consultant San Rafael, CA 94901 [:]COM World Placement Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 1,350.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) RA - -1- - - ^ - - d -'1 d' r•. SCHEDULE A (CONT.) ivionetary lrontrlDlJtlonS Kecelvea Amounts may ne rounded Statement covers period to whole dollars. 9E10:3 from 01/01/2022 page 9 of 31 through 09/24/2022 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 07/28/2022 Lucia Martel Dow x❑IND Director 150.00 150.00 G2022 $150.00 ❑COM Immigrant Legal Resource Sari Rafael, CA 94903 ❑ OTH Center Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/26/2022 Denise Esterkyn x❑IND Not Employed 100.00 100.00 G2022 $100.00 ❑COM n/a San Rafael, CA 94901 E] OTH Received through intermediary: Donorbox ❑ P- y 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/23/2022 Sarah Ferris x❑IND Photographer 200.00 200.00 G2022 $200.00 [:] COM Sarah Ferris San Rafael, CA 94 901 F-1 OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 F-1 SCC Arlington, VA 22204 09/16/2022 Dianne Fruin X❑IND Not Employed 100.00 100.00 G2022 $100.00 n/a Sari Rafael, CA 94901 El COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 09/07/2022 Regan Gough Hobbs x❑IND Recruiter 100.00 100.00 G2022 $100.00 Isaacson Miller Kentfield, CA 94904 El COM OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑SCC *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 www.netfile.com SUBTOTAL $ 650.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) MonetaryContributions Received Amounts may be rounded Statement covers period to whole dollars. • from 01/01/2022 �. • through 09/24/2022 page 10 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/16/2022 Veronica Alvarez Grajeda x❑IND Director of Admissions 100.00 100.00 G2022 $100.00 F-1 COM High Tech High San Diego, CA 92109 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 08/18/2022 Jim GruettnerX❑IND Talent Partner 300.00 300.00 G2022 $300.00 ❑ COM Artium Sari Rafael, CA 94901 OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 08/23/2022 Lauren Hardy Smith x❑IND Registered Nurse 100.00 100.00 G2022 $100.00 ❑COM Sutter Health San Francisco, CA 94123 OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 09/06/2022 Katharine Hatch E] IND Psychologist in Private 100.00 100.00 G2022 $100.00 F1 COM Practice San Rafael, CA 94901 Katharine Hatch Received through intermediary: ❑ OTH Donorbox El PTY2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 09/01/2022 Marie Henrio 91 IND CBO 100.00 100.00 G2022 $100.00 Miller Creek School San Anselmo, CA 94960 ❑COM District Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ ScC SUBTOTAL$ 700.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) IVIV1IVI,df �Vr�triputions Keceivea Amounts may De rounaea Statement covers period to whole dollars. CALIFORNIA 460 from 01/01/2022 FORM Page 11 of 31 I.D. NUMBER through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) G2022 $100.00 09/07/2022 Jill Hetherington IND Biz Dev 100.00 100.00 ❑ COM Newfront Hillsborough, CA 94 010 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 09/07/2022 Tyler Hoyt RI IND Retail 150.00 150.00 G2022 $150.00 El COM Hoyts Sisters, OR 97759 ❑ OTH Received through intermediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/26/2022 Oliver Hurst -Hiller X❑IND Staff 100.00 100.00 G2022 $100.00 [:]COM DonorsChoose San Francisco, CA 94110 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #-27 El SCC Arlington, VA 22204 08/24/2022 Linda Jackson x❑IND Consultant 200.00 200.00 G2022 $200.00 Linda Jackson San Rafael, CA 94901 El COM ❑ OTH ❑ PTY ❑ SCC 08/20/2022 Anne Jacobs RIND Executive Assistant 250.00 250.00 G2022 $250.00 UC Davis Davis, CA 95616 ❑COM OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 800.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 4601, from 01/01/2022 FORM through 09/24/2022 Page 12 Of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 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 ENTER IDNUMBER) NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 07/29/2022 Brent JarcikX❑IND Finance Executive 250.00 250.00 G2022 $250.00 ❑ COM Oakland Athletics Sari Rafael, CA 94901 Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 08/03/2022 Kevin JenkinsX❑IND Housing Director 150.00 150.00 G2022 $150.00 ❑ COM United Way Bay Area Oakland, CA 94619 OTH Received through intermediary: ❑PTY Donorbox 2615 Columbia Pike, #427 Arlington, VA 22204 El SCC 08/18/2022 Caroline Jensenx❑IND Admin 100.00 100.00 G2022 $100.00 ❑ COM Marin Community Foundation San Rafael, CA 94901 ❑ OTH Received through inte Donorbox mediary: ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 09/18/2022 Steven Juliani X❑IND Musician 150.00 150.00 G2022 $150.00 ❑ COM Steven Juliani San Rafael, CA 94901 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 07/30/2022 Paula Kamena x❑IND Retired 500.00 500.00 G2022 $500.00 ❑ COM n/a San Rafael, CA 94901 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 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 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Iviunewry %.pontrioutlons Kecelvea Amounts may De rounaed Statement covers period to whole dollars.CALIFORNIA 460 from 01/01/2022 • - Page 13 of 31 I.D. NUMBER through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONT CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/23/2022 Andy Kaplan RIND Not Employed 100.00 100.00 G2022 $100.00 n/a Boynton Beach, FL 33473 ❑COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/31/2022 Anne Kaplan RIND Communications 100.00 100.00 G2022 $100.00 COM PG&E San Rafael, CA 94901 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 09/05/2022 Barbara Kautz Mx IND Attorney 500.00 500.00 G2022 $500.00 ❑COM Goldfarb & Lipman LLP Tiburon, CA 94920 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 09/08/2022 Nicole Laborde x❑IND Design Researcher 200.00 200.00 G2022 $200.00 ❑COM Sutherland Labs San Rafael, CA 94901 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 09/19/2022 Nicole Levine MX Nonprofit Consulting 100.00 100.00 G2022 $100.00 Nicole Levine Sausalito, CA 94965 El COM OTH Received through inte mediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑SCC *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 1,000.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. / � 1 from 01/01/2022 � through 09/24/2022 page 14 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 11449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 08/03/2022 Sara Levine x❑IND Philanthropy 250.00 250.00 G2022 $250.00 ❑COM Rogers Family Foundation Oakland, CA 94610 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 09/12/2022 Karen Little 91 IND Social Impact 100.00 100.00 G2022 $100.00 ❑ COM PayPal Sari Rafael, CA 94 9 01F-1 OTH Received through inte mediary : Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ��++ El SCIi 08/19/2022 Raul Lomeli FK] IND Chairman 500.00 500.00 G2022 $500.00 ❑COM Welcome Tech, Inc San Antonio, TX 78259 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 F1 SCC 08/23/2022 Mayra Contreras Lopez X❑IND Director of Partnerships 100.00 100.00 G2022 $100.00 ❑ COM TMC CC Modesto, CA 95355 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08 20 2022 Paige Luben X❑IND Chief of Staff 100.00 100.00 G2022 $100.00 ❑ COM IGT Sari Ramon, CA 94582 Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑SCC SUBTOTAL$ 1,050.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) IVIU11t:Ldfy VUntrioutions Kecelvea Amounts may oe rounaea Statement covers period to whole dollars.CALIFORNIA t from ol/0l/2022 • - • page 15 of 31 I.D. NUMBER through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 250.00 08/25/2022 Kristin Maguire X❑IND Not Employed 250.00 G2022 $250.00 n/a San Rafael, CA 94901 ❑COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 100.00 08/22/2022 Megan Mariani x❑IND Finance 100.00 G2022 $100.00 COM Gap Inc San Rafael, CA 94901 ❑ OTH Received through inte mediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/17/2022 Jonathan Marker x❑IND Philanthropy 200.00 200.00 G2022 $200.00 RoadAviv F-1 COM Foundation Arnold, MD 21012 E] OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, # 27 El SCC Arlington, VA 22204 07/30/2022 Carolina Martin RX 500.00 500.00 G2022 $500.00 San Rafael, CA 94901 F-1 COM ❑ OTH ❑ PTY ❑ SCC 08/17/2022 Monica Martin X❑IND Sr Data Center Technician 150.00 150.00 G2022 $150.00 NVIDIA San Jose, CA 95112 ❑COM OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY —Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 1,200.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from 01/01/2022 through 09/24/2022 page 16 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 07/28/2022 Lidia S Martinez x❑IND Not Employed 260.00 260.00 G2022 $260.00 ❑COM n/a San Diego, CA 92101 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC 08/17/2022 LaWand MathernX❑IND Business Development 100.00 100.00 G2022 $100.00 ❑ COM Labcorp San Rafael, CA 94901 OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 F-1 SCC 09/15/2022 Ann Mathieson x❑IND Chief Executive Officer 250.00 250.00 G2022 $250.00 ❑COM Marin Promise Partnership Kentfield, CA 94904 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/19/2022 Matthew McCabe x❑IND Teacher 100.00 100.00 G2022 $100.00 ❑COM San Rafael City Schools Larkspur, CA 94939 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/25/2022 Danielle McCarthy X❑IND Not Employed 200.00 200.00 G2022 $200.00 ❑ COM n/ a San Rafael, CA 94901 Received through intermediary ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 910.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may De rounaea Statement covers period — Recipient Committee to whole dollars.CALIFORNIA (other than PTY or SCC) 460 — Other (e.g., business entity) from 01/01/2022 • page 17 of 31 I.D. NUMBER — Small Contributor Committee through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) G2022 $500.00 08/25/2022 Meghan McCray x❑IND Events Marketing 500.00 500.00 F] COM Exabeam San Rafael, CA 94901 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 F-1 SCC Arlington, VA 22204 100.00 100.00 08/19/2022 Caitlin D McShane MIND Public Relations G2022 $100.00 ❑COM EMC Communications San Rafael, CA 94903 F] OTH Received through intermediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 08/26/2022 Erika Mehrer x❑IND Not Employed 250.00 250.00 G2022 $250.00 n/a Mill Valley, CA 94941 ❑COM E:1 OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/29/2022 Fiona Mills x❑IND Teacher/Administrator 500.00 500.00 G2022 $500.00 ❑ COM The Loomis Chaffee School Simsbury, CT 06070 ❑ OTH Received through inte mediary : Donorbox ❑ PTY 2615 Columbia Pike, #,27 ❑ SCC Arlington, VA 22204 08/23/2022 Bri Monaghan x❑IND Therapist 250.00 250.00 G2022 $250.00 Bri Monaghan Sari Rafael, CA 94901 El COM OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 1,600.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. 460 from 01/01/2022 FORM1 through 09/24/2022 page 18 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 08/22/2022 Jennifer Moore x❑IND Not Employed 100.00 100.00 G2022 $100.00 ❑ COM n/a San Rafael, CA 94 901 Received through inte mediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 09/07/2022 Lindsey Moriguchix❑IND Nonprofit Specialist 100.00 100.00 G2022 $100.00 ❑COM Raise for Good Artesia, CA 90701 OTH Received through intermediary: Donorbox ❑PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 09/07/2022 Frank Murrayx❑IND Not Employed 150.00 150.00 G2022 $150.00 ❑COM n/a San Rafael, CA 94901 F-1 OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 07/28/2022 Thalassa Naylor X❑IND Business Development 150.00 150.00 G2022 $150.00 ❑COM Sallie Mae Fair Oaks, CA 95628 ❑ OTH Received through intermediary: Donorbox F1 PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/20/2022 Kaetlyn OBrien Dagle X❑IND Not Employed 150.00 150.00 G2022 $150.00 ❑ COM n/a San Rafael, CA 94901 Received through inte mediary: ❑ OTH Donorbox F-1 PTY 2615 Columbia Pike, # 27 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 650.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may oe rounaea Statement coversperiodto whole dollars. � t from 01/01/2022 • • page 19 of 31 I.D. NUMBER through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 150.00 150.00 08/31/2022 Siobhan O'Donoghue x❑IND Capital Project Manager G2022 $150.00 San F-1 COM Biomarin Rafael, CA 94901 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 F] SCC Arlington, VA 22204 150.00 150.00 09/10/2022 Joe OHehir X❑IND Not Employed G2022 $150.00 COM n/a San Rafael, CA 94901 ❑ OTH Received through intermediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/15/2022 Robin Pendoley x❑IND Educator 250.00 250.00 G2022 $250.00 ❑COM Marin Promise Partnership San Rafael, CA 94903 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 G2022 $100.00 08/19/2022 Kelly Phu [_X1 IND Restaurateur 100.00 100.00 Vin Antico Sari Rafael, CA 94901 ❑COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/21/2022 Beth Porter x❑IND Nonprofit Management 150.00 150.00 G2022 150.00 Giant Steps Therapeutic Hingham, MA 02043 ❑COM Equestrian Center OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 *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 www.netfile.com SUBTOTAL $ 800.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from 01/01/2022 FORM through 09/24/2022 Page 20 Of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 11449397 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 09/03/2022 Julia Prietox❑IND Chief Operating Officer 100.00 100.00 G2022 $100.00 ❑COM Donors Choose Brooklyn, NY 11217 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #127 Arlington, VA 22204 ❑ SCC 08/22/2022 Carolyn Reiserx❑IND Attorney 150.00 150.00 G2022 $150.00 ❑COM Shartsis Friese San Francisco, CA 94114 OTH Received through intermediary: ❑PTY Donorbox 2615 Columbia Pike, #427 Arlington, VA 22204 El SCC 09/13/2022 Pamela Rhyner x❑IND Not Employed 100.00 100.00 G2022 $100.00 F] COM n/a San Rafael, CA 94901 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/23/2022 Carol Rivero FX] IND Program Manager 100.00 100.00 G2022 $100.00 ❑ COM Google San Francisco, CA 94110 Received through intermediary ❑ OTH Donorbox ❑P- ry 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/23/2022 Rodoni for Supervisor x❑IND Supervisor 200.00 200.00 G2022 $200.00 ❑COM County of Marin Ol ema , CA 94950 Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC SUBTOTAL$ 650.00 *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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Ivionetary %.ounirmutions Kecelvea Amounts may ne rounded Statement covers period to whole dollars. CALIFORNIA460 from 01/01/2022 • - page 21 of 31 through 09/24/2022 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/21/2022 Aaron Rosenthal RIND Vice President 500.00 500.00 G2022 $500.00 Las F] COM Penn Entertainment Vegas, NV 89145 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #-27 ❑ SCC Arlington, VA 22204 G2022 $300.00 08/17/2022 Janice Rosenthal x❑IND Not Employed 300.00 300.00 F-1 COM n/a Henderson, NV 89014 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #,27 El SCC Arlington, VA 22204 08/09/2022 Katie Rosenthal BIND Not Employed 150.00 150.00 G2022 $150.00 StAmazon ❑COM Web Services Sari Diego, CA 92117 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #,27 ❑ SCC Arlington, VA 22204 08/02/2022 Jennifer Schaeffer RX Finance 500.00 500.00 G2022 $500.00 F1 COM CAC Specialty Larkspur, CA 94939 OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 F-1 SCC Arlington, VA 22204 08/10/2022 Andrew Schultz x❑IND Attorney 500.00 500.00 G2022 $500.00 Sari ❑ COM U.S. Government Rafael, CA 94 901 OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, # 27 El SCC Arlington, VA 22204 *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee www.netfile.com SUBTOTAL$ 1,950.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA 460 from 01/01/2022 FORM through 09/24/2022 page 22 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 09/02/2022 Adrienne Sherk X❑IND Sales 100.00 100.00 G2022 $100.00 DriveUnite F-1 COM Us Novato, CA 94949 OTH Received through intermediary: F-1 Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 El SCC 09/20/2022 Thomas Silverman X❑IND Vice President 150.00 150.00 G2022 $150.00 El COM BuildOn San Francisco, CA 94117 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/22/2022 Sarah Stoddart x❑IND Not Employed 250.00 250.00 G2022 $250.00 ❑ COM n/a Oakland, CA 94611 OTH Received through intermediary: ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 08/01/2022 Sarah Stroth x❑IND International Trade 150.00 150.00 G2022 $150.00 Sari Rafael, CA 94901 ❑COM Consultant N.F. Stroth & Assoc Received through intermediary: ❑ OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 F-1 SCC 08/12/2022 Stephen Thompson x❑IND Sr Director 100.00 100.00 G2022 $100.00 San Jose, CA 95125 ❑COM Nike Received through intermediary: ❑ OTH Donorbox ❑ P-ry 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC *Contributor Codes IND—individual COM —Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 750.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) IVIVI ICLa1 vU11L1 1 JUL1U115 Mt!k;U1VeU Hrrivunts may De rounaea Statement covers period to whole dollars. � • 460 from 01/01/2022 • Page 23 of 31 through 09/24/2022 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORIF CONTRIBUTOR AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 100.00 100.00 08/19/2022 Brent Tippen x❑IND Public Affairs - G2022 $100.00 Oakland, F] COM Healthcare CA 94611 Abbott ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #,27 ❑ SCC Arlington, VA 22204 150.00 150.00 08/20/2022 Natu Tuatagaloa x❑IND Consultant G2022 $150.00 COM Whyspeople San Rafael, CA 94901 ❑ OTH Received through intermediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 08/24/2022 Michelle Unruh x❑IND Not Employed 250.00 250.00 G2022 $250.00 n/a San Rafael, CA 94901 COM ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, # 27 ❑ SCC Arlington, VA 22204 200.00 200.00 09/23/2022 Chris Untermann x❑IND Not Employed G2022 $200.00 n/a San Rafael, CA 94901 ❑COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 100.00 100.00 09/22/2022 Emily Vasquez x❑IND Not Employed G2022 $100.00 n/a San Rafael, CA 94901 ❑COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 *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 www.netfile.com SUBTOTAL $ 800.00 FPPG Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. • • from 01/01/2022 _ • through 09/24/2022 Page 24 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 11449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 08/25/2022 Sarah N Velasquez El IND Strategy Director 100.00 100.00 G2022 $100.00 [:]COM Starbucks Coffee Company Houston, TX 77019 ❑ OTH Received through inte Donorbox mediary: ❑ PTY 2615 Columbia Pike, #,27 Arlington, VA 22204 ❑ SCC 09/08/2022 Charity Wagnerx❑IND Land Developer 100.00 100.00 G2022 $100.00 ❑ COM WE LLC San Rafael, CA 94903 Received through intermediary: ❑OTH Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 08/19/2022 Ashley Walter FK] IND Not Employed 100.00 100.00 G2022 $100.00 ❑ COM n/a San Rafael, CA 94 901 ❑ OTH Received through inte Donorbox mediary: ❑ PTY Columbia Pike, #427 Arlington, VA 22204 Arlington, �-+ ❑ SCC 07/31/2022 Brooks Washington x❑IND Investor 1,000.00 1,000.00 G2022 $1,000.00 ❑ COM Roha Durham, NC 27705 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 Arlington, VA 22204 ❑ SCC 08/03/2022 Marie Washington x❑IND Not Employed 1,000.00 1,000.00 G2022 $1,000.00 El n/a Durham, NC 27705 Received through intermediary: ❑ OTH Donorbox PTY 2615 Columbia Pike, #127 ❑ Arlington, VA 22204 ❑ SCC SUBTOTAL$ 2,300.00 *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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) 1V1U11VLdry k-ountriuutlons Kecelvea Amounts may oe rounaea Statement covers period to whole dollars. CALIFORNIA460 from 01/01/2022 • - page 25 of 31 through 09/24/2022 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) G2022 $100.00 08/17/2022 Gretchen Weber x❑IND Designer 100.00 100.00 AvenueGoogle ❑ COM Stoneham, MA 02180 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 G2022 $250.00 08/03/2022 Amber Weiss x❑IND Marketing 250.00 250.00 [:]COM ALCON Fort Worth, TX 76108 ❑ OTH Received through intermediary: ❑ PTY Donorbox 2615 Columbia Pike, #427 ❑SCC Arlington, VA 22204 08/17/2022 Samantha Wiesler X❑IND Filmmaker 180.00 180.00 G2022 $180.00 El COM Gush San Francisco, CA 94110 ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 09/11/2022 Kathy Williams X❑IND Not Employed 500.00 500.00 G2022 $500.00 n/a San Rafael, CA 94901 F] COM ❑ OTH Received through inte mediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 ❑ SCC Arlington, VA 22204 07/22/2022 Toni. Wilson X❑IND Not Employed 250.00 250.00 G2022 $250.00 n/a Sari Rafael, CA 94901 COM OTH Received through inte mediary : ❑ Donorbox ❑ PTY 2615 Columbia Pike, #427 El SCC Arlington, VA 22204 *Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 1,280.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) MonetaryContributions Received Amounts may be rounded Statement covers period to whole dollars. • • from 01/01/2022 �_ through 09/24/2022 page 26 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 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 ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/18/2022 Lisa Wolford X❑IND Not Employed 150.00 150.00 G2022 $150.00 ❑COMn/a San Rafael, CA 94901 ❑ OTH Received through intermediary: Donorbox ❑ PTY 2615 Columbia Pike, #427 �-+ El SCIi Arlington, VA 22204 ❑ IND ❑COM ❑ OTH ❑ PTY El SCC ❑ IND El COM ❑ OTH ❑ PTY ❑SCC F-1 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 Statement covers period from 01/01/2022 through 09/24/2022 SCHEDULE E Page 27 of 31 I.D. NUMBER 1449397 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 LIT 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Bank of America LIT 347.76 San Rafael, CA 94901 CJ & Associates, Inc. PRO 192.50 Antelope, CA 95843 CJ & Associates, Inc. PRO 268.93 Antelope, CA 95843 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 809.19 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.) ............................. TOTAL $ www.netfile.com 9,330.78 50.00 0.00 9,380.78 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA ,� ' to whole dollars. Payments Made from 01/01/2022 FORM SEE INSTRUCTIONS ON REVERSE through 09/24/2022 Page 28 of 31 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CJ & Associates, Inc. PRO 116.65 Antelope, CA 95843 Miguel Carlo G David WEB 900.00 Carson, CA 90745 Miguel Carlo G David WEB 58.17 Carson, CA 90745 Dyana Delfin Polk CNS 2,000.00 Berkeley, CA 94709 Donorbox OFC 1,089.66 Arlington, VA 22204 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,164.48 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Amounts may be rounded Statement covers period Payments Made to whole dollars. Y from 01/01/2022 SEE INSTRUCTIONS ON REVERSE through 09/24/2022 NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 SCHEDULE E (CONT.) Page 29 of 31 I.D. NUMBER 1449397 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 LIT campaign literature and mailings PRT print ads WEB information technoloav costs (internet. e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Carolina Martin FIL 225.00 San Rafael, CA 94901 Rhett Jones Jr Photography LIT 350.00 Oakland, CA 94605 ScanArt CMP 3,782.11 Emeryville, CA 94608 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,357.11 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.neffile.com www.fppc.ca.gov Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 fro Statement covers period m 01/01/2022 through 09/24/2022 SCHEDULE F Page 30 of 31 I.D. NUMBER 1449397 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR CODE OR (a) OUTSTANDING (b) AMOUNT INCURRED (c) AMOUNT PAID (d) 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 Bank of America WEB 0.00 161.44 0.00 161.44 San Rafael, CA 94901 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0.00$ 161.44$ 0.00$ 161.44 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.) ............................................ INCURRED TOTALS $ 161.44 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.) ................................. PAID TOTALS $ 0.00 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................ NET $ 161.44 May be a negative number www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 NAME OF AGENT OR INDEPENDENT CONTRACTOR Bank of America Statement covers period from 01/01/2022 through 09/24/2022 SCHEDULE G Page 31 of 31 I.D. NUMBER 1449397 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 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 summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Political Data Intelligence WEB 161.44 Long Beach, CA 90806 ScanArt LIT 347.76 Emeryville, CA 94608 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 509.20 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov