HomeMy WebLinkAboutForm 497 - Maribeth Bushey for Council D3 2022; 09-02-2022497 Contribution Report Amounts may be rounded to whole dollars
NAME OF FILER Date of 09/02/2022 p Qi e
Re-elect Maribeth Bushey San Rafael City Council District 2 2022 This Filing
AREACODEIPHONE NUMBER I.D. NUMBER (if applicable) M64SR-1 TOfftlal Use Only
( 1452093 Report No.
STREETADDRESS SEP - 2 2022
❑ Amendment
to Report No.
CITY STATE ZIP Copt= (explain below) 1 CITY CLERK'S OF -ICE
San Rafael CA 94901 No. of Pages
1. Contribution(s) Received
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.co.gov
IF AN INDIVIDUAL,
DATE
FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE,ALSO ENTER 1 D. NUMBER)
CODE'
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
Kate Colin
is IND
Mayor
1000.00
09/01/2022
❑ COM
❑ OTH
City of San Rafael
Check If
San Rafael, CA 94901
❑ Loan
❑ PTY
❑ SCC
°b
Provide Interest rat
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Prwde 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.co.gov