HomeMy WebLinkAboutForm 497 - Maribeth Bushey for Council D3 2022; 10-17-2022497 Contribution Report
NAME OF FILER
Re-elect Maribeth Bushey San Rafael City Council istrict 3 2022
AREA CODE IPHONE NUMBER I.D. NUMBER (rleppfi.ble)
( 11452093
CITY STATE ZIP co
San Rafael CA 94901
1. Contribution(s) Received
Amounts may be rounded to whole dollars.
Date of 10/17/2022
This Filing
Report No. MWR-5
❑ Amendment
to Report No.
(explain below)
No. of Pages 1
1H
IN
OCT 1 7 2022
CLERK'S OFFi
Official Use Only
DATE
FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER 1 D. NUMBER)
CODE"
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
❑ IND
10/15/2022
Marin Professional Firefighters Political Action Committee
m COM
2450.00
All -Purpose Account (ID #930791)
[3 Check if Loan
PTY
❑ SCC
%
Provide Interest rate
❑ IND
❑ COM
❑ OTH
E3 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 - Smell Contributor Committee
FPPC Form 497 (Feb/2019)
FPPC Advice: advice@fppc.ca.gov (966/275-3772)
www.fppc.ca.gov