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497 Contribution Report 181012-01 - Contribution Received on 10-12-18 Q��r�3�$��"i�?L$'�lf��'1 ��$�� Amoucots�reay be rcunded to rn�e�te do3iars_ 497COM'RiBtJTlON�FORT __ ,. __ - - _ . NAtuiE OF�!{FR �ate O� _ • � ' i Cupertino Residents far Loaa1 Ethical Go�exnment �jiPS�1�iEl� ��1212Q3$ � p�� U 1�� (� S ' , _ AREACODEIPHONE NUM6ER I.D.NUMSER{ifaPWicabte) ', a '�! �7� l? � ��t'f��"riCidk�3S��t3��' , R�pc�rt�io.�sia12-oi � � � �� ' ( f. V��E��UG�Q��.�9� ��.�.�.�v�.Li __ I�AN IN�iVIDURt, DRTE FULL NASNE.STREEi"ADDRESS AND ZiP CODE OF CONTRiBUTOR � CO�l+f218UTOR � � AMOUN3 RECElVED pFcormHrrree,c,isoerrr�:..�.NumeFsz7 COdE i` 'EtdTEF2f3CGUPATlOivANDERAPLC3YER RECEtVED - F SELF-EMPLOYED,ENTEE2 t3AhtE OF BUSINESS} �olii/zais azey�s �r�al� & Tap3.ng, �.c , � E3�lD 2,�00_00 Q �O� � {)TEi p Gheck if Loan � PT1' ❑ SCC � � � . � Provide interesY raYe 1OJ31{2€318 �S Plumbing, Inc. - 3,500_00 � COM U OTH Q�heck if Loan ❑ PiY ❑ SCC � Pro�ide interest rate _ _ �' _ ❑ �t�o ❑ coM ❑ OTH ❑ check if Loan ❑ � ❑ SCC i ' Provide interest rate *Gontributor Codss INt'�—Individual ' COM—f�ecipient Committee(other ttian PTY or SCC) ' OTH—Other(�_g_,busiaess entity} PTY—Paiitiea{Pa�y Resscn for Amendment: SCC—SmailContributarCornmittee FPFC Forrsi 487{Jarst2016j �FPC Advice:advice@fppc.ca.gov 486fii27�-3772)