The URL can be used to link to this page

Home My WebLink AboutForm 460 - Maribeth Bushey for Council D3 2022; 10-27-22COVER PAGE Recipient Committee Campaign Statement MIE G IE 0 V,12 •. • 1 Cover Page Statement covers period Date of electio lica@l1K 2 7 2022 Page 1 of from 09/25/2022 (Month, r) For Official use Only SEE INSTRUCTIONS ON REVERSE I through 10/22/2022 1. Type of Recipient Committee: All committees—Complete Parts 1, 2, 3, and 4. m Dfficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee ommittee Q Recall Controlled (nrso Compk*Pari s) Sponsored (Aho Comp&e Part 6) ❑ neral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Alm CompkbParf 7j 3. Committee Information I.D. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 STREET ADDRESS (NO P.O BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O BOX CITY STATE zip CODE AREA CJODEiPHONE OPTIONAL: FAX/ E-MAILADDRESS November i Mn CLARK'S OFFICE 2. Type of Statement: ® Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Mark L. Kyle, Esq. MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE 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 my By Signature of Controlling Officeholder, Candidate, State Measure Proponent By signature of Controlling Ottioeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ce.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 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, District 3, City of San Rafael, CA RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael CA 94901 Related Committees Not Included in this Statement: Lisrany 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. I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO COMMITTEE CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO COVER PAGE - PART 2 Page 2 of 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee L/stnames of officeholder(s) or candidete(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 CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.co.gov Campaign Disclosure Statement Summary Page NAME OF FILER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 Amounts may be rounded to whole dollars. Statement covers period from 09/25/2022 through 10/22/2022 Page 3 Contributions Received Column A TOTALTHIS PERIOD Column B CALENDARYEAR 6. Payments Made................................................................ schedule E, Line 4 (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetary Contributions................................................... schedule A, Line 3 $ 23905.00 $ 31629.00 2. Loans Received................................................................ schedule a, line 3 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add lines 1 +2 $ 23905.00 $ 31629.00 4. Nonmonetary Contributions ............................................ schedule c, Line 3 0.00 811.19 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 23905.00 $ 32440.19 Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 $ 14872.83 $ 15281.64 7. Loans Made....................................................................... schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS ........................ Add Lines 6+7 $ 14872.83 $ 15281.64 9. Accrued Expenses (Unpaid Bills) ..........................................schedule F, Line 3 0.00 0.00 10. Nonmonetary Adjustment......................................................... schedule c, Line 3 0.00 811.19 11. TOTAL EXPENDITURES MADE....................................Add Lines 6+g+10 $ 14872.83 $ 16092.83 Current Cash Statement 12. Beginning Cash Balance ........... Previous summary Page, Line 16 $ 7315.19 13. Cash Receipts .. column A, Line 3 above 23905.00 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 0.00 15. Cash Payments......................................................... column A, Line a above 14872.83 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 16347.36 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED... ..... ................. Schedule Part $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see inshuctions on reverse $ 0.00 19. Outstanding Debts .............................. Add Line 2 +Line 9/n Column 8 above $ 0.00 To calculate Column B, add amounts in Column Ato the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). SUMMARY PAGE of 1452093 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 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) $ *Amounts in this section may be different from amounts reported in Column B. FPPC Farm 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to wnoie oonars. Statement covers period , • . , i from 09/25/2022 • • " through 10/22/2022 Page 4 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/25/2022 Carole Dillon Knutson m I N D Retired 100.00 100.00 ❑ COM ❑ OTH 94945-1215 ❑ PTY ❑ scC 9/26/2022 Nina Kwan m I N D Lawyer 500.00 500.00 ❑ COM ❑ OTH 94901 ❑ PTY ❑ SCC 9/27/2022 Stephanie Plante ®IND real estate management 500.00 500.00 ❑ COM ❑ OTH CPI Developers 94941 ❑ PTY ❑ SCC 9/27/2022 Marin Women's PAC (#13325045) ❑ IND 200.00 200.00 m COM ❑ OTH 94914 p PTY ❑ SCC 9/28/2022 William Bagley ®IND Retired 250.00 250.00 ❑ COM ❑ OTH 94901 ❑ PTY ❑ scc SUBTOTAL $ 1550.00 Schedule A Summary Amount received this period — itemized monetary contributions. 23,830.00 (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 75,00 3. Total monetary contributions received this period. 23905.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ ' *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 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period , from 09/25/2022 ■ - • through 10/22/2022 page 5 of NAME OF FILER I.D. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 FULL NAME, STREETADDRESS AND ZIP CODE OF IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR + OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/29/2022 Garbarino Investments ❑ IND 2500.00 2500.00 ❑ COM ® OTH 94901 ❑ PTY ❑ SCC 9/30/2022 Thomas Monahan ® IND President 4900.00 4900.00 ❑ COM ❑ OTH Monahan Pacific Co. 94901 ❑ PTY ❑ SCC 9/30/2022 Charles Litchfield ®IND Real estate broker 1000.00 1000.00 ❑ CoM ❑ OTH Litchfield Brokers 94901 ❑ PTY ❑ SCC 10/01/2022 Sushma Taylor ®IND Psychologist 1000.00 1000.00 ❑ COM ❑ OTH Center Point Inc. 94901 ❑ PTY ❑ SCC 10/01/2022 Frances Scher ® IND Retired 130.00 130.00 ❑ COM ❑ OTH 94903 ❑ PTY rl SCC SUBTOTAL $ 9530.00 '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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from 09/25/2022 s • 0 Page 6 of through 10/22/2022 IJAME OF FILER I.D. i .UMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR WAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE,ALSO ENTER 1.0 NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10/02/2022 Gary Ragghianti ®IND Attorney 500.00 500.00 ❑ coM ❑ OTH Ragghianti Freitas LLP 94901 ❑ PTY ❑ SCC 10/06/2022 SRCC Candidates PAC (#1281286) ❑ IND 2500.00 2500.00 ®COM mom 94901-3208 El PTY ❑ SCC 10/04/2022 Jack Robertson ® IND Real estate developer 100.00 100.00 ❑ COM ❑ OTH Tableau Development Co. 94901 ❑ PTY ❑ SCC 10/04/2022 Roger Smith ®IND Manager 100.00 225.00 ❑ COM ❑ OTH Smith Brothers 2 94901 ❑ PTY ❑ SCC 10/04/2022 Lynn Taylor ® IND Mediator/Arbitrator 250.00 250.00 ❑ coM ❑ OTH JAMS 94901 ❑ PTY I-1 ScC SUBTOTAL $ 3450.00 `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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to wnoie aouars. Statement covers period from 09/25/2022 - Page 7 of through 10/22/2022 NAME OF FILER I.D. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN.1 - DEC. 31) (IF REQUIRED) 10/04/2022 Marin Builders Association PAC (ID# 760140) ❑ IND 500.00 500.00 ® COM ❑ OTH 94903 ❑ PTY ❑ ScC 10/05/2022 William Carney ® IND Retired 100.00 100.00 ❑ CoM ❑ OTH 94901 ❑ PTY ❑ SCC 10/05/2022 Jack Nixon ®IND Financial advisor 500.00 500.00 ❑ CoM ❑ OTH Westhill Financial Advisors 94901 ❑ PTY ❑ SCC 10/05/2022 North Bay Leadership Council PAC (ID #1246290) ❑ IND 500.00 500.00 ® COM ❑ OTH 94901 ❑ PTY ❑ SCC 10/09/2022 Neil Moran ® IND Retired 250.00 250.00 ❑ CoM ❑ OTH 94901 ❑ PTY SCC SUBTOTAL $ 1850.00 "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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period 0. , from 09/25/2022 . - ' • Page 8 of through 10/22/2022 NAME OF FILER ED. NUMBER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 1452093 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR WAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * U OCCUPATION AND EMPLOYER P RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10/10/2022 Albert Boro ® IND Retired 100.00 100.00 ❑ COM ❑ OTH 94901 ❑ PTY ❑ SCC 10/15/2022 Marin Professional Firefighters PAC (#930791) ❑ IND 2450.00 2450.00 ® COM ❑ OTH 95814 ❑ PTY ❑ ScC 10/18/2022 1101 Fifth Avenue, LLC ❑ IND 4900.00 4900.00 ❑ coM ® OTH 94901 ❑ PTY ❑ ScC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 7450.00 *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 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 SCHEDULE E Amounts may be rounded Statement covers period to whole dollars. from 09/25/2022 through 10/22/2022 I Page 9 of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1452093 CMP campaign paraphernalia/misc. MBR member communications RAD 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 t.v. 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 TRS 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 PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID eFundraising Connections WEB fees for website -based fundraising application $199.50 Sacramento, CA 95816 Cornerstone Printing, Inc. POS $306.53 Novato, CA 94949 PMCohen Public Affairs CNS $3500.00 San Rafael, CA 94915 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4006.03 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)........................................................................... 2. Unitemized payments made this period of under $100........................................................................................................ 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.) ...... S 14872.83 $ 0.00 $ 0.00 . TOTAL $ 14872.83 FPPC Farm 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 SCHEDULE E (CONT.) Statement covers period CALIFORNIA from 09/25/2022 FORM through. 10/22/2022 Page 10 of I.D. NUMBER 1452093 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD 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 t.v. 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 TRS 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 PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID PMCohen Public Affairs reimburse for purchase of electronic voter file to be used $800.00 for public outreach San Rafael, CA 94915 four waters media, inc. ballot stmt., consulting, project management $1655.00 West Sacramento, CA 95691 four waters media, inc. Lir walk cards $2136.80 West Sacramento, CA 95691 four waters media, inc. WEB website development, social media development + $6275.000 POL maintenance, messaging + press, consulting, project West Sacramento, CA 95691 management * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 10866.80 FPPC Form 454 (!an 2076)) FPPC Advice: advice@fppc.ce.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Amounts may be rounded to whole dollars. statement covers penoa from 09/25/2022 through 10/22/2022 SCHEDULE G Page 11 of NAME OF FILER Re -Elect Maribeth Bushey San Rafael City Council District 3 2022 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Political Data Intelligence Norwalk, CA 90652 political data - voter file for San Rafael City Council District 3 $800.00 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 800,00 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov