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HomeMy WebLinkAboutForm 497- Maribeth Bushey-Lang for City Council 2013 (2013-10-29)z Ld IL 0 TiAME OF F[LER rkliari beth Bushey Lang for San Rafae[ Ci4r 0)uncil 2013 AREA C0DE1PHGNE N UMBER F.D. NUMBER (ff Wsm&le) ( 1358370 STREET ADDRESS c1W STATE San Rafael CA Type or P rant in ink. Amounts may be rounded to whole dollars. Date of 10/29/13 This F Hi ng Report No. 497-10-3 ©,amendment to Report No. ZIP CODE (p3pla-wit be -Amy) 94901 No. of Pages FLJi-L NIAM.E MEET ADDRESS ANO ZIP CODE OF CONTROUTOR (4F CO [A M n- EE, AlS0 0 ec YE -R J.D. N U &�s,EF.} Perty Utchfield San Rafael, CA 94901-2316 Date Stamp I [F AX INDIV40U,41, ENTER OCCUPATION AND EMPLOYER (41F_ SV-f-eAPJL0YED, EWTER W.ME OF BUSINESS) Businessman, gz- elf-employed • $13750.00 0 Che&, if Loan Pmvide inbefesi raie ■ M 01 -Check if Loam &t Pmeode inbarea rate 'ConDibutor Codes IND — fndividual COL15 — RedpkA Corrumitt ee (Oher than PTY or SCC) OTH — Other (e.g., business -entj P Ty — Political Par4r SCC — SMall Conbiti-utor Committee FPPC Form 497 (March[2011) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)