HomeMy WebLinkAboutForm 465 - Police Association PAC (Bushey-Lang)Supplemental Independent
Type or print in ink.
SUPPORT
X
OPPOSE
I
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Expenditure Report
(Government Code Section 84203.5)
Amounts may be rounded to
whole dollars.
Report covers period
from 10/20/2013
OPPOSE
Date Stam p,
SEE INSTRUCTIONS ON REVERSE
El Amendment (Explain Below)
through 12/31/2013
Page of 2
For Official Use Only
Date of election if applicable:
(Month, Day, Year)
11/05/2013
1. Committee/Filer Information
I.D. NUMBER (If recipient committee)
831553
Treasurer (if recipient committee)
COMM ITTEE/FILER'S NAME
NAME OF TREASURER
San Rafael Police Association Political Action Committee
Ms. Beth Dinka
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS
1520 Fifth Avenue
1520 Fifth Avenue
CITY STATE
ZIP CODE AREA CODE/PHONE
CITY
STATE ZIP CODE AREA CODE/PHONE
San Rafael CA, 94901
(415) 485-3000
San Rafael CA, 94901
(415) 485-3000
OPTIONAL: FAX / E-MAIL ADDRESS
OPTIONAL: FAX / E-MAIL ADDRESS
2. Name of Candidate or Measure Supported or Opposed
CHECK ONE
NAME OF CANDIDATE
Maribeth Bushey -Lang
OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE
City Council Member City of San Rafael, CA
SUPPORT
X
OPPOSE
I
NAME OF BALLOT MEASURE
BALLOT NO./LETTER
JURISDICTION
SUPPORT
OPPOSE
3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets. CUMULATIVE TO DATE
DATE NAME AND ADDRESS OF PAYEE DESCRIPTION OF EXPENDITURE AMOUNT CALENDAR YEAR
(JAN. 1 - DEC. 31)
Freeman Public Affairs, Inc. 5,870.50
1405 Marcelina Avenue, Suite 111 Mailer including production and postage
10/25/2013 in support of Maribeth Bushey -Lang for 10,759.50
City Counci
Torrance, CA 90501
U.S. Postmaster 2,900.00
Postage for mailer in support of MEMO
10/25/2013 1433 Marcelina Avenue Maribeth Bushey -Lang for San Rafael Subpayment made through:
City Council Freeman Public fair,
Torrance, CA 90501 Inc. t
FPPC Form 465 (June/09)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Supplemental Independent Type or print in ink. SUPPLEMENTAL INDEPENDENT EXPENDITURE
Amounts may be rounded Report covers period A,
Expenditure Report to whole dollars. 0
from 10/20/2013
SEE INSTRUCTIONS ON REVERSE through 12/31/2013 Page 2 of 2
NAME OF FILER I.D. NUMBER (If recipient corn.)
San Rafael Police Association Political Action Committee 831553
4. Summary 5,870.50
1. Total independent expenditures of $100 or more made this period. (Part 3.) ........................................................................................... $
2. Total i 0.00
ndependent expenditures under $100 made this period. (Not itemized.) ........................................................................................ $
3. Total independent expenditures made this peri5,870.SO
period(Add Lines 1 + 2.) .......................................................................................... TOTAL $
5. Filing OfficerS Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been Red.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
San Rafael City Clerk
ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET)
1400 5th Avenue
CITY STATE ZIP CODE CITY STATE ZIP CODE
San Rafael, CA 94901
2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET)
CITY STATE ZIP CODE CITY STATE ZIP CODE
FPPC Form 465 (June/0
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3771