497 Contribution Report - Contributions Received on 11-03-2016 - Amendment z
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497 Contribution Report Amounts may be rounded to whole dollars. �
497CONTRIBUTION REPORT
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NAME OF FfLER Dafe oF P�'f
NO ON C AC7D 16S OT] D - CRfPBRTTNO 31EICHBD�S, ED(ICA�RS, AND TH8 r� /� (� (� ��] � � L � o
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kREACoDE1PHOVE NU�416ER I.O.NUACBER(day���rahte) � Fot O�Cial Use Only �
Repo�t No,uR #1291F �
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��7y STk7E ZIP CODE (explain be7aH) z
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1. Contributian(s) Received �
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IF AM INDIVI Dl1kL,
DATE FUL�NMAE,STREET AODRESS A��1D ZIP CODE OF CONTRIBIfTaR CONTRIBUTOR ENTER OCCUPATIONAtJD EAIPLOYER N��i�U�JT
RECEIVEO (IFCO\fVfTiEE,A�SOElaT£RI�JNUV.I6FF) CODE r pFSELPEI.IPLOYED,EI7TFRN:JdEOFBL151NESS] R�CEIVED
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11/03/2016 CUPBRTINO CHA[•183R PkC � IND � 7,619.96
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CommitLee ID � 1299673 .
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11/03/2016 SA?!D H1LL PROPHRTY COh1PA17Y AC]D A?PILIATHD 6NTITTES 10,000.00
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Reason for Arnendrnenl: To IJICLUDE AODITIONAL KON-IaolieraeY CON�RIBUTIOI7 PTY—POIIUCeIP2fly o
SCC-Small Conlri bulor Cammillee
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FPPC Form 497(Janl20�6)
FPPC Advice:advfce�Fppc.ca.gov�866l275-3772)
viww,fppc,ca.gov
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