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Home My WebLink AboutForm 460 - Maribeth Bushey for Council D3 2022; 06-30-25Recipient• Campaign CoverPage SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/2025 through 06/30/2025 1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ State Candidate Election Committee Committee ❑ Recall ❑ Controlled (Ako complete Parf 6) f� Sponsored (Ain Com,clele Part6) ❑ General Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Ako C-Plete Part 7) 3. Committee Information I.D. NUMBER Re -Elect Maribeth Bushey Saga Rafael City Council District 3 2022 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( MAILINGADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS U L - 7 2025 Date of election if (Month, Day, CLERK'S OFFICE 11/08/2022 �CI 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) COVER PAGE ❑ Quarterly Statement ❑ Special Odd -Year Report of 4 NAME OF TREASURER Mark L. Kyle PAICIMADMES9 CITY STATE ZIPCODE AREA CODE/PHONE San Rafael CA 94901 ( NAME OF ASSISTANT TREASURER, IFANY MAILING ADDRESS CITY STATE ZIPCODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of Sponsor Executed on By DateSignature o? Controlling Mceholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent _ FPPC Form 460 (Jan/2026)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwAppc.ca.gov 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 this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME NAME I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIPCODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 4 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 OR DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee tistnames of officeholder(s) or candidate(s) for which this committee is primarily 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 if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period I from 01/01/2025 1 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re -Elect Maribeth Bushey, San Rafael City Council, District 3, 2022 Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1, Monetary Contributions ................................................... schedule A, Linea $ 0.00 2. Loans Received ................. .............................................. Schedule B, Line 3 0.00 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines I + 2 $ 0.00 4. Nonmonetary Contributions ........................................... Schedule C, Line 3 0.00 5. TOTAL CONTRIBUTIONS RECEIVED ................................. 4dd Lines 3 + 4 $ 0.00 through 06/30/2025 Column B CALENDAR YEAR TOTAL TO DATE $ 0.00 0.00 $ 0.00 0.00 $ 0.00 6. Payments Made .................... ........................................... Schedule E, Line 4 $ 318.00 318.00 7. Loans Made .................................................................... . .. Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6 + 7 $ 318.00 $ 318.00 9. Accrued Expenses (Unpaid Bills) ....... .................................. schedule F Line 3 0.00 0.00 10. Nonmonetary Adjustment ......................................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ............... ....... ........ ... AddLines 8+ 9+ 10 $ 318.00 $ 318.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 1149.01 To calculate Column B, 13. Cash Receipts ........................................................... Column A, Line 3 above 0.00 add amounts in Column 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 0.00 A to the corresponding amounts from Column B 15. Cash Payments ......................................................... Column A, Line 8 above 318.00 of your last report, Some 831.01 amounts in Column A may 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ be negative figures that should be subtracted from ff this is a termination statement, Line 16 must be zero, previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Part 2 $ 0.00 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if 18. Cash Equivalents ................................................ see instructions on reverse $ 0.00 any). 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0.00 Page 3 of 4 1452093 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1 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 Limit) Date of Election Total to Date (mm/dd/yy) *Amountsin this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE Re -Elect Maribeth Bushey, San Rafael City Council, District 3, 2022 Statement covers period from 01/01/2025 through 06/30/2025 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULEE ;ALIFORNIIA FORM 460' I.D. NUMBER 1452093 CMP campaign paraphernalia/misc. MBR member communications RAID 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 tv. 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 TIRS 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 PIRT 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) California Secretary of State FIL Annual Fee $50.00 1500 1 lth Street, Rm. 495, Sacramento CA 95814 Law Office of Mark Kyle PRO $250.00 San Rafael CA 94901 Bank of Marin OFC Bank fees $18.00 1101 Fourth Street, San Rafael CA 94901 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 318.00 1. Itemized payments made this period. (include all Schedule E subtotals.) ....... 318.00 2. Uniternized 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)) ..................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) $ 0.00 TOTAL$ 318.00 FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov