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SEE INSTRUCTIONS ON REVERSE ro �eu V P Filer Must Check Applicable Box: Complete D A For Official Use Only
Part: 22 1912 0 Reporting Late Contribution(s) Received: I ❑ Reporting Late Contribution(s) Made:
NAME OF FILER STREET ADDRESS
Patricia H. Birdsall 41540 Avenida Barca
AREA CODE /PHONE NUMBER I. D. NUMBER(ifapplioblQ CITY STATE ZIP CODE
. 10909- 676 -4657 891031 Temecula, C alifornia 92591
1 Late Contribution(s) Received From: II Late Contribution(s) Made To:
NAME ID. NUM BEA fifappliuble) NAME OF CANDIDATE OR COMMITTEE: - LD. NUMBER
Birdsall's Tax Service
Mark J. Birdsall
ADDR[SS CITY STATE ZIP CODE ADDRESS CITY STATE ZIP(ODf
28671 Calle Cortez, Ste F, Temecula, California 92590
OC CUPATION /EMPLOYER OR NAME OF BUSINESS IF SF LFEMPLOYED(ll applicable) Of FICE SOUGHT BY CA HDID A TE OR BALLOT NO ILE TIE R AND IURI SORT ION
self - employed
DATE RECEIVED AMOUNT DATE MADE: AMOUNT DATE OF ELECTION
10 / / 89 $ 11000.00 — /— / $ — /_ /—
NAME LET. NUMBER (it applicable) NAMEOFUNDIDATE ORCOMMITTEF: LD. NUMBER
Johnson + Johnson Development
ADDRESS CITY STATE ZIPCODE ADDRESS CITY STATE ZIP CODE
27450 Ynez Road, Temecula, California 92591
OCCUPATIONI[MPLOYER OR NAME OF BUSINESS If SELF- EMPLOYLD(Ifappllcable) OFFICE SOUGHT BY CANDIDATE OR BALLOT NO.AETTER AND JURISDICTION
Self-employed
DATE RECEIVED AMOUNT DATE MADE AMOUNT DATE OF ELECTION
1/ 20 / 89 $ 1,000.00 _ / /_ S
NAME I. D. NUMBER (it applicable) NAME Of CANDIDATE OR COMMITTEE: LD. NUMBER
ADDRESS CITY STATE ZIP CODE ADDRESS CITY STATE ZIP CODE
OCCUPAIIONIEMPLOYER OR NAME Of BUSINESS If SELF EMPLOYED(II applicable) OFFICE SOUGHT BY CANDIDATE OR BALLOT NO /LETT ER AND JURISDICTION
DATE RECEIVED: AMOUNT DATE MADE AMOUNT DATE Of ELECTION
- - -- / It $ — /— /— S /— /—
10R 1111 ORMATION REQUIRED r0 BE PROVIDED 10 YOU PURSUANT TO IIA INf ORMA [ION PRACTICES ACT Of 1971, SEE IN ORMAIION MANUAI ON CAMPAIGII DISCSOSU PI[OVIS Of III[ P0I IIICAL REFORM ACT
1 - State of California Fair Political Practices Co Mmiseion.