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HomeMy WebLinkAboutForm 497 - Rachel Kertz for City Council 2024; 10-02-24497 Contribution Report Amounts may be rounded to whole dollars. NAME OF FILER Committee Date of 10/01/2 IE Z t VnE to Re-elect Rachel Kertz for San Rafael City Council 2024 This Filing 3 _ AREA CODE/PHONE NUMBER I.D. NUMBER (d applicable) 1473447 Report No. For Official Use Only r n. n, r, 24 STREETADDRESS ❑ Amendment to Report No. (explain below) �d fC 6J OFFICE CITY STATE ZIP CODE Novato CA 94945 No. of Pages � 1. Contribution(s) Received IF AN INDIVIDUAL, DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE' (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED Marin Professional Firefighters Political Action Committee ❑ IND $2,500 10/Ol/2024 COM Sacramento, CA 95814 ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide 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.ca.gov