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Form 497- Lucia Martel Dow for San Rafael School Board 2022; 10-18-22497 Contribution Report Amounts may be rounded to whole dollars. CONTRIBUTOR ENT ER IF AN INDIVIDUAL, OCCUPATION AND EMPLOYER AMOUNT RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) 497 CONTRIBUTION REPORT NAME OF FILER Date of�� • 0 d ' Lucia Martel Dow for San Rafael School Board 2022 This Filing 10/18/2022 D v AREA CODE/PHONE NUMBER I.D. NUMBER (if applicable) Immigrant Legal Resource Center San Rafael, CA 94903 "ial Use Only Report No. 221017-1 ❑ OTH ❑ Check if Loan ( 1442869 ❑ PTY OCT 1 8 202 1. Contribution(s) Received DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENT ER IF AN INDIVIDUAL, OCCUPATION AND EMPLOYER AMOUNT RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED 10/17/2022 Lucia Martel Dow Nonprofit Director 2,000.00 ❑X IND Immigrant Legal Resource Center San Rafael, CA 94903 ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC % Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC r Provide interest rate Reason for Amendment: "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 497 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov