497 Contribution Report 3 - Contributions Received on 10-19-18 497 COtltt"IbUt10C1 R@�JOI"t Amounts may be rounded to whole dollars.
taanne oF Fi�ER� �� Date of /� G, �� !� � !S i3 � l� ' �• " � �
�y� � ( This Filing � � � � �
No.of Pa es
1. Contribution(s) Received
IFAN INDIVIDUAL, AMOUNT
DATE FULL NAME,STREETADDRESSAND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATIONAND EMPLOYER
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) � CODE 'F (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) RECEIVED �
�{ P�� �� �� 0 OM �Q�l�� � �r��V r
� ��
� � � ����cf� �/ ���� /����� ❑ OTH �� � ��,�,���� Check if Loan
�
❑ 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)
OTH — Other(e.g.,business entity)
Reason forAmendment: PTY — Poiiticai Party
SCC — Small Confributor Committee
FPPC Form 497(Jul/2016)
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www.ipPc.ca.gov