497 Contribution Report – Contributions Receied on 08-12-2016 – Amendment 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of 09/26/1 � Dat�e Stamp � _ � �
Parth Bharwad Tn'S F'i'"g D �_� (C,� (� �j `�/ L' � '
NUMBER I.D.NUMBER(ifapplicable) � ` 0� �CIe Se n y
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10511 Madera Dr to Report Na
(explain below)
CITY STATE ZIP CODE �� �'���;^1 p'j'�`„i (�'E�W �'Z
No.of Pages � ����. �.�F a f !:'�. _, � 3 � ���, , �
Cupertino CA 95014 � ,
1. Contribution(s) Received
DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, AMOUNT
ENTER OCCUPATION AND EMPLOYER RECEIVED
RECEIVED QF COMMITTEE,ALSO ENTER LD.NUMBER) CODE * (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS)
❑ coM $1,900
08/12/16 Cupertitlo, CA 95014 ❑ OTH ❑ Check if Loan
❑ PTY
❑ SCC �
Provide interest rate
❑ IND
❑ COM
❑ OTH ❑Check if Loan
❑ PTY
❑ SCC �
Provide interest rate
❑ IND
❑ COM
❑ OTH ❑ Check if Loan
❑ PTY
❑ SCC ��
Provide interest rate
�'*Contributor Codes `
IND — Individual
COM— Recipient Committee(other than PTY or SCC)
Originally recorded as $2,000 but the actual amount was $1,900 - OTH — Other(e.g.,business entity)
PTY — Political Party
Reason for Amendment: SCC — Small Contributor Committee
accounting error �
� FPPC Form 497(lul/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov