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Form 460 - Lucia Martel Dow for San Rafael School Board 2022; 10-28-22Recipient Committee COVER PAGE Campaign Statement �?` Stamp - Cover Page FM, , (Government Code Sections 84200-84216.5) Statement covers period Date of election if appli ! C72022 1 � ! 1 (Month, Day, Year) f , a 8 v# 00 from J 1 -- For Official Use Only lg i t'" " ' � ��' SEE INSTRUCTIONS ON REVERSE through I ID aoaa- 11/08/2022 �_ i; b t 1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. 2. Type f Statement: ❑x Officeholder, Candidate Controlled Committee EJ Primarily Formed Ballot Measure Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part 5) O Sponsored Also file a Form 410 Termination ( ) Statement -Attach Form 495 (Also ComplelePart 6J F-1GeneralPurpose Committee ❑ Amendment (Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) 1442869 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Lucia Martel Dow for San Rafael School Board 2022 Lucia Martel Dow MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE Novato CA 94949-5731 ( CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Novato CA 94949-5731 ( Nancy L Warren MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94949-5731 ( OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of Executed on By Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Dale Signature ofControdngOfficeholder. Candidats. Stals Measure Proponanl FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) 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. 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 COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of 10 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 ❑ 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) Campaign Disclosure Statement SUMMARYPAGE Amounts may be rounded Statement covers period 4 Summary Page to whole dollars. J from 09/25/2022 � -.- - I -- Lucia Martel Dow for San Rafael School Board 2022 through 10/22/2022 Page 3 of 10 I.D. NUMBER 1442869 Expenditures Made Column A 6. Payments Made ......... ..........:................................... Column B Calendar Year Summary for Candidates Contributions Received 7. Loans Made............................................................. TOTALTHISPERIOD CALENDARYEAR Running in Both the State Primary and 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ (FROM ATTACHED SCHEDULES) TOTALTO DATE Schedule F Line 4,845.25 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 4,150.00 $ 9, 024.00 1/1 through 6130 7/1 to Date 2. Loans Received...................................................... schedule a, Line 3 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 4 ,150.00 $ 9,024.00 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 $ 4,150.00 $ 9,024.00 Made $ $ Expenditures Made 6. Payments Made ......... ..........:................................... Schedule E, Line 4 $ 1,187.591 7. Loans Made............................................................. Schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 1,187.91 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 4,845.25 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 6,033.16 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 2,113.80 13. Cash Receipts ................................................... Column A, Line 3 above 4.150.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 0.00 15. Cash Payments .................................................. Column A, Line 8 above 1,187.91 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 5,075.89 If this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents . See instructions on reverse $ 0.00 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 5,109.62 $ 3,948.11 0.00 $ 3,948.11 5,109.62 0.00 $ 9,057.73 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 (8661275-3772) c..r,o.fi iro A SCHEDULE A - - - - - - Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period e - from 09/25/2022 " through 10/22/2022 Page 4 of l0 SEE INSTRUCTIONS ON REVERSE NAME 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 (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) IF REQUIRED) OF BUSINESS) 10/11/2022 California Federation of Teachers COPE (ID# [FIND 500.001 500.00 G2022 $500.00 741857) ❑COM ❑ OTH Sacramento, CA 95814 ❑ PTY Z SCC 10/20/2022 International Brotherhood of Electrical El IND 500.00 500.00 G2022 $100-00 Workers Local 551 PAC (ID# 1277746) COM ❑ OTH Sacramento, CA 95814 ❑ PTY ❑ SCC 10/15/2022 Marin Professional Firefighters Political ❑IND 750.00 750.00 G2022 $750.00 Action Committee (ID# 930791) [KCOM ❑ OTH Sacramento, CA 95814 ❑ PTY ❑ SCC 09/26/2022 Marin Women's PAC (ID# 1332045) ❑IND 200.00 200.00 G2022 $200.00 ❑X COM San Rafael, CA 94903 ❑ OTH ❑ PTY ❑ SCC 10/17/2M Lucia Martel Dow ❑x IND Nonprofit Director 2,000.00 2,000.00 G2022 $2,000.00 ❑COM Immigrant Legal Resource San Rafael, CA 94903 Center ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 3,950.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)........................................................................................................ $ 4,150.00 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 $ 0.00 4,150.00 "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 (866/2753772) Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from 09/25/2022 ' Page 5 of 10 through 10/22/2022 NAME 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 COMMrrrEE,ALSO ENTER I.D.NUMBER) CODE x (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 10/20/2022 North Bay Labor Council AFL-CIO COPE (ID# ❑IND 200.00 200.00 G2022 $200-05 744444) X❑ COM OTH Santa Rosa, CA 95405-7540 ❑ ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC [:]IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC —Small Contributor Committee SUBTOTAL$ 200.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) 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 09/25/2022 through 10/22/2022 Page 6 of 10 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1442869 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 ND 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) Anedot New Orleans, LA 70112 Anedot New Orleans, LA 70112 Citicard New York, NY 10013 CODE OR FND FND WEB DESCRIPTION OF PAYMENT AMOUNT PAID 8.30 80.30 48.63 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 137.23 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. .. ..... $ 1,187.91 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0.00 3. Total interest paid this period on loans. Enter amount from Schedule B Part 1 Column e $ 0.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 1.187.91 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E SCHEDULE E (COP (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA I to whole dollars. • ' I Payments Made from 09/25/2022 through 10/22/2022 page 7 Of 10 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 paraphernalialmisc. 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 PEF petition circulating TT3 t.v. or cable airtime and production costs FiL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FIND fundralsing events POL polling and survey research TRS stafr/spause 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) _ Firefighters Print & Design CMP 639.30 Sacramento, CA 95833 Firefighters Print & Design Sacramento, CA 95833 ScanArt Emeryville, CA 94608 CMP 195.64 215.74 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,050.68 FPPC Form 460 (Jan/2016) eoor r u_cse ue�..r..e. Qaarwe�r_eoor raaai��a_z���� Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCT[ NAME OF FILER AM PP\/PPCF Lucia Martel Dow for San Rafael School Board 2022 Amounts may be rounded to whole dollars. Statement covers period from 09/25/20 through 10/22/2022 SCHEDULEF F"'LlA 46U f .- Page 8 of 10 I.D. NUMBER 1442869 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CWP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MfG 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 ND 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) (a) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING OF THIS PERIOD Citicard 1WEB 48.63 1 New York, NY 10013 (b) AMOUNT INCURRED THIS PERIOD Citicard LIT / POS 0.00 New York, NY 10013 Miguel Carlo G. David WEB 0.00 Carson, CA 90745 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 48.63$ 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 $100.) ..... I.......... 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)............................................................................................................... 0.00 3,576. (c) (d) AMOUNT PAID OUTSTANDING THIS PERIOD BALANCE AT CLOSE (ALSO REPORT ON E) OF THIS PERIOD 48.63 0.00 0.00 3,576.77 0.0 4,116.77$ 48.63$ INCURRED TOTALS $ 540.00 4,116.77 5,109.62 ........... PAID TOTALS $ 264.37 NET $ a,6�5.25 May ho a negativ.+ number FPPC Form 460 (Jan/2016) Schedule F (Continuation Sheet) Amotowholedollars.nts may be rounded Statement covers period Accrued Expenses (Unpaid Bills) from 09/25/2022 through 10/22/2022 NAME OF FILER Lucia Martel Dow for San Rafael School Board 2022 CODES: If one of the following codes accurately describes the payment, you may enter the code. CK/P campaign paraphernalia/misc. MBR member communications CNS campaign consultants WITG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) Lrr campaign literature and mailings FRT print ads * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) ScanArt Emeryville, CA 94608 wepac LLC Novato, CA 94949 CODE OR DESCRIPTION OF PAYMENT CMP PRO/OFC Otherwise, describe the payment. SCHEDULE F (CONT.) Page 9 of 10 I.D. NUMBER 1442869 RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) (a) (b) OUTSTANDING AMOUNT INCURRED BALANCE BEGINNING THIS PERIOD OF THIS PERIOD _I 215.79 0.00 SUBTOTALS $ 215.74$ 0.0 992.8 992.85$ (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) 215.74 0.00 215.74 $ (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD 0.00 992.85 992.85 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Lucia Martel Dow for San Rafael School Board 2022 NAME OF AGENT OR INDEPENDENT CONTRACTOR Citicard Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) UT campaign literature and mailings PRT print ads * 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) Firefighters Print & Design Sacramento, CA 95833 Firefighters Printers paid USPS $877.21 for postage Attach additional information on appropriately labeled continuation sheets. Statement covers from 09/25/2022 through 10/22/2022 page 10 of 10 I.D. NUMBER 1442869 Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TB_ t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) CODE OR DESCRIPTION OF PAYMENT / POS AMOUNT PAID 3,576.77 TOTAL* $ 3,576.77 * 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. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772)