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Home My WebLink AboutForm 460 - Carolina Martin for San Rafael School Board Trustee 2022 12-31-22Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200.84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 10/23/2022 through 12/31/2022 1. Type of Recipient Committee: All Committees - Complete Paris 1, 2, 3, and 4. ❑x Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (AlsoCon4W;ePat5) Q Sponsored (Also Comdata Part e) ❑ General Purpose Committee O Sponsored Q Small Contributor Committee Q Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Al- Comdata Part 7) COVER PAGE D C -TI C,'R''RM . Date of election if app 3 ^^:�3 age 1 12 (Month, Day, Year j 3 L -1 [ j (� For Official Use Only �jFI'IV 11/08/2022 I CLERK'S VE 2. Type of Statement: ❑ Preelection Statement ❑ quarterly Statement Semiannual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) 3. Committee InformationI I.D. NUMBER Tmasur+er(s) Executed on ! 1449397 Date COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Carolina Martin for San Rafael City Schools District 4 2022 Chelsea Johnson Date MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE Antelope CA 95843 ( CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Antelope CA 95843 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS AREA CODE/PHONE CITY STATE ZIP CODE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS ( 4, Verification 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 perjury under the laws of the State of California that the foregoing is true Executed on 01/23/2023 Date Executed on 01/23/2023 Date Executed on Deft Executed on Date By By BY Sig ab- orCatulUng Dffladmkbr, Carte, State Meamm Proponent BY sigkftmofCanmomnyorr. er'canaaem'smteMeawmProporem FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275.3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Carolina Martin OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Board of Education City of San Rafael District 4 RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael CA 94901 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 an behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 12 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 ibrmed. 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 (8661275-3772) www.tppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SummaryPage to whole dollars. Statement covers period from 10/23/2022 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE I through 12/31/2022 I Page 3 of 12 NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Runningin Both the State Puma and (FROMATTACHEDSCHEDULES) TOTALTODATE Primary General Elections 1. Monetary Contributions ........................................... ScheduleA, Line 3 2. Loans Received...................................................... schedule s, Line 3 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +2 4. Nonmonetary Contributions ................................... schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 Expenditures Made 6. Payments Made ....................................................... schedule E, Line 4 7. Loans Made............................................................. Schedule ri, Line 3 8. SUBTOTAL CASH PAYMENTS ................................... Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ........I ...................... Schedule F, Linea 10. Nonmonetary Adjustment .......................................... Schedule C,Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 13. Cash Receipts ................................................... column A, Line 3above 14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 15. Cash Payments .................................................. column A, Line a 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. $ 1,100.00 0.00 $ 1,100.00 250.00 $ 32,164.00 0.00 $ 32,164.00 1,575.00 $ 1,350.00 $ 33,739.00 $ 11,755.59 0.00 $ 11,755.59 -4,866.75 250.00 $ 7,138.84 $ 15,938.03 1,100.00 0.00 11,755.59 $ 5,282.44 17. LOAN GUARANTEES RECEIVED Schedule 8, 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 $ 0.00 $ 26,881.56 0.00 $ 26,881.56 0.00 1,575.00 $ 28,456.56 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). 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Lim it) Date of Election (mm/dd/yy) $ Total to Date I $- *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) www.fppc.ca.gov Schedule A SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period • - ■ 11 6 from 10/23/2022 through 12/31/2022 Page 4 of 12 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 DATE NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERID.NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 11/04/2022 Marin Professional Firefighters PAC (ID# ❑IND 750.00 750.00 62072 $750.00 930791) (ECOM MOTH Sacramento, CA 95814 ❑ PTY []SCC 11/04/2022 North Bay Labor Council (ID# 744444) []IND 200.00 200.00 G2022 $200.00 ❑% COM Santa Rosa, CA 95405 E] OTH ❑ PTY ❑ SCC 10/27/2022 •Jose Ramos ❑x IND Staff 100.00 100.00 G2022 $100.00 ❑COM Non -Profit Organization ;San Ramon, CA 94582 ❑0TH Received through inter. iary- El PTY Donorbox Columbia Pike, #427 F] SCC Arlington, VA 22204 11/04/2022 Brent Tippen [X]IND Public Affairs - 50.00 150.00 G2022 $150.00 ❑COM Healthcare Oakland, CA 94611 ❑ OTH Abbott Received through inteq. Donorbox diary: ❑ PTY 2615 Columbia Pike, #,I V ❑ SCC Arlington, VA 22204 []IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1,100.00 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.) ............ 1,100.00 $ 0.00 .... TOTAL $ 1,100.00 *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 (8661275-3772) www.fppc.ca.gov Schedule C SCHEDULE C wmounts may oe rounueu Nonmonetary Contributions Received to whole dollars.CALIFORNIA Statement covers period 0.00 ...... TOTAL $ . , from 10/23/2022FORM • through 12/31/2022 Page 5 of 12 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE IF REQUIRED) (IF COMMITTEE, ALSO ENTER I D NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) 0/27/2022 California Federation of Teachers COPE ❑IND In -Kind, Digital 250.00 1, 575.0062022 $1,575.Of (ID# 741857) X ❑COM Ads Burbank, CA 91505 ❑OTH ❑PTY In -Kind ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY [:]SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ! ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)........................................................................................ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ....... 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...... SUBTOTAL $ 250. $ 250.00 $ 0.00 ...... TOTAL $ . 250.00 "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 (8661275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Carolina Martin for San Rafael City Schools District 4 2022 Statement covers period from 10/23/2022 through 12/31/2022 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 6 of 12 I.D. NUMBER 1449397 CIVIP campaign paraphemalia/mist. 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 AMOUNTPAID Bank of America WEB i I 161.44 San Rafael, CA 94901 Bank of America j ISee Schedule G for Individual Payees I 3,993. I 1 San Rafael, CA 94901 Bank of America I POS 74.66 San Rafael, CA 94901 a Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 4,229.75 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .................................. 11, 755.59 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 $ 11, 755.59 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 through 12/31/2022 SCHEDULE E Page 7 of 12 I.D. NUMBER 1449397 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW 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) Bank of America See Schedule G for Individual Payees 1,321.86 San Rafael, CA 94901 Bank of America See Schedule G for Individual Payees 637.00 San Rafael, CA 94901 Bank of America See Schedule G for Individual Payees 531.70 San Rafael, CA 94901 CJ & Associates, Inc. PRO 655.08 Antelope, CA 95843 Miguel Carlo G David WEB 900.00 Carson, CA 90745 e Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,045.64 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) ......... V___ — —, Schedule E (Continuation Sheet) Payments Made NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 through 12/31/2022 SCHEDULE E Page 8 of 12 I.D. NUMBER 1449397 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CHIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants WM 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 Miguel Carlo G David WEB 23.00 Carson, CA 90745 Miguel Carlo G David WEB 450.00 Carson, CA 90745 Dyana Delfin Polk CNS 2,500.00 Berkeley, CA 94709 Donorbox OFC 7.20 Arlington, VA 22204 Alexander McCoy PHO 500.00 Berkeley, CA 94703 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3,480.20 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866IASK-FPPC (8661275-3772) Schedule F Accrued Expenses (Unpaid Bills) SEEINSTRUGTI NAME OF FILER ON RFVFRSF Carolina Martin for San Rafael City Schools District 4 2022 Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 through 12/31/2022 SCHEDULE F Page 9 of 12 I.D. NUMBER 1449397 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating 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 PRF print ads WEB information technology costs (Internet, e-mail) * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 873.10$ 0.00$ 873.10$ 0.00 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 $ 0.00 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 $ 4,866.75 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................................................................................................ NET $-4, 866.75 y be a negabve number FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) b c NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID 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 161.44 0.00 161.44 0.00 San Rafael, CA 94901 Bank of America See Schedule G for 637.001 0.00 637.00 0.00 Individual Payees San Rafael, CA 94901 Bank of America POs 74.66 0.00 74.66 0.00 San Rafael, CA 94901 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 873.10$ 0.00$ 873.10$ 0.00 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 $ 0.00 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 $ 4,866.75 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................................................................................................ NET $-4, 866.75 y be a negabve number FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 through 12/31/2022 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULE F (CONT.) Page 10 of 12 I.D. NUMBER 1449397 CNP 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 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 UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT ( OUTSTAA NDING BALANCE BEGINNING OF THIS PERIOD ( AMOUNTIN CURRED THIS PERIOD (c) AMOUNTPAID THIS PERIOD (ALSO REPORT ON E) ( OUTSTANDING BALANCE ATCLOSE OF THIS PERIOD Bank of America San Rafael, CA 94901 See Schedule G for Individual Payees 3,993.65 0.00 3,993.65 0.00 SUBTOTALS $ 3,993.65$ 0.00$ 3,993.65 $ 0.00 FPPC Form 460 (Jan/2016) FPPCToll-Free Helpline: 8661ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period 6 - , , to whole dollars. 10/23/2022 6 - ' Contractor (on Behalf of This Committee) from through 12/31/2022 page 11 of 12 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Carolina Martin for San Rafael City Schools District 4 2022 1449397 NAME OF AGENT OR INDEPENDENT CONTRACTOR Bank of America CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalia/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 UVEB 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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER LD NUMBER) Julie's Hummus Bar MTG Appetizers Only 233.73 San Rafael, CA 94912 Peerly, Inc. PHO 719.64 Huntsville, AL 35801 Peerly, Inc. PHO 359.82 Huntsville, AL 35801 ScanArt LIT 368.49 Emeryville, CA 94608 Affach additional information on appropriately labeled continuation sheets. * 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. TOTAL* $ 1,681.68 FPPC Forth 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.tppc.ca.gov Schedule G (Continuation Sheet) Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SEE INSTRUCTIONS NAME OF FILER Carolina Martin for San Rafael City Schools District 4 2022 NAME OF AGENT OR INDEPENDENT CONTRACTOR Bank of America Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 through 12/31/2022 SCHEDULE G Page 12 of 12 I.D. NUMBER 1449397 CODES: If one of the following codes accurately describes the payment, you may enter the code, Otherwise, describe the payment. CNP campaign paraphemalia/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 FIND 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 (intemet, 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 ScanArt Emeryville, CA 94608 LIT 171.88 Attach additional information on appropriately labeled continuation sheets. * 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. TOTAL* $ 171.88 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov