HomeMy WebLinkAboutForm 470 - Maribeth Bushey 2020Officeholder and Candidate
Campaign Statement —
Short Form
Date of election if applicable: I ❑ Amendment (Explain Below) I u ul Q — 2 2�2
(Month, Day, Yeah C
1. Statement Covers Calendar Year 20 20
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Maribeth Bushey
STREET ADDRESS
CITY STATE ZIP CODE
San Rafael CA 94901
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX I E-MAILADDRESS
(
Council Member
City of San Rafael
CLERK'S OFFI
4. Committee Information
List all Committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMITTEE NAME AND I.D. NUMBER
None
5. Verification
COMMITTEE ADDRESS
(IFAPPLICABLE)
3
NAME OF TREASURER
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $2,000 and that I will spend less than $2,000 during the calendar year and that I have used
all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on August 2, 2021
DATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov