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Home My WebLink AboutForm 460 - Maribeth Bushey for Council D3 2022; 12-31-23Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2023 through 12/31/2023 1. Type of Recipient Committee: Au Committees —Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee 0 Recall O Controlled (AkocompterePed5) Q Sponsored ❑ General Purpose Committee W-Complete PartBJ Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (AbD ComptetePart7) 3. Committee Information I.D. NUMBER 1452093 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re —Elect Maribeth Bushey San Rafael City Council District 3 2022 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS ' " A, ?4 Date of election if (Month, Day, I 2. Type of statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVERPAGE 1 of 4 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Mark L. Kyle Esq. MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification 1 have used all reasonable diligence in preparing and reviewing this statement and to the By s,,reofngor,o�am,cande,stateMa,rerx FPPC Form 460 (Jan/2016) advlco@fppc.ca.gov (866/275-3772) www.fppc.ca.gov FPPC Advice Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Maribeth Bushey OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member City of San Rafael District 3 RESIDENTIALlBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael CA 94901 Related Committees Not Included in this Statement: List any committees not included in thts statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behaH of your candidacy. COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME II.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET CITY STATE ZIP CODE AREA CODE/PHONE www.netriile.com COVER PAGE - PART 2 Page 2 of 4 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION I ElSUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 primadly 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 Attach continuation sheets N necessary FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.gov (866(275.3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SummaryPage to whole dollars. Statement covers period from 07/01/2023 SUMMARYPAGE SEE INSTRUCTIONS ON REVERSE I through 12/31/2023 I Page 3 of 4 NAME OF FILER I.D. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPEROD CALE»DARVEAR Primary Runningin Both the State Prima and (FROMATTACHEDSCFEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ........................................... schedule A, Line 3 $ 0.00 $ 0.00 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... schedule e, Line 3 0.00 0.00 3. SUBTOTALCASH CONTRIBUTIONS Add Lines 1 +2 $ o. oo $ 0.00 20. ContributionsReceived ......................... $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED•.•.•..•••.••••••.••••.•••• Add Lines 3+4 $ 0.00 $ 0.00 Made $ $ Expenditures Made 6. Payments Made ....................................................... schedule E, Line a $ 7. Loans Made............................................................. schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... schedule F, Line 3 10. Nonmonetary Adjustment .......................................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 250.00 $ 0.00 250.00 $ 0.00 0.00 250.00 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 1,705.01 13. Cash Receipts ................................................... Column A, Line 3 above 0.00 14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 0.00 15. Cash Payments .................................................. column A, Line 8above 250.00 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,455.01 ff this is a terminedon statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... schedule a, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ see instructions on reverse $ 19. Outstanding Debts ......................... Add Line2+Line9/nCo/umnElabove $ www.netrile.com 0.00 0.00 300.00 0.00 300.00 0.00 0.00 300.00 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* QfSub)ect to Voluntary Expenditure Limit) Date of Election Total to Date (mmfdd/yy) *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice&ppc.ca.gov (866/275-3772) www.fope.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Re —Elect Maribeth Bushey San Rafael City Council District 3 2022 Statement covers period from 07/01/2023 through 12/31/2023 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 4 of 4 I.D. NUMBER 1452093 CAP campaign paraphemalia/misc. NBR member communications RAD radio airtime and production costs CNS campaign consultants MI'G 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 TIC 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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE OF COMMITTEE, ALSO ENTER I.D. NUMBER) Law Offices of Mark Kyle 25 San Rafael, CA 94901 CODE OR DESCRIPTION OF PAYMENT PRO AMOUNT PAID 250.00 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 250.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ www.neffile.com 250.00 0.00 0.00 250.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov