497 Contribution Report 5 - Contributions Received on 10-25-18 497 Contribution Report Amoungs may be rounded to whofe dollars.
NAME OF FILr R �� � ,� `�^ � Date Of j � �� Date Stam � . ,
0`f G This Filing L ^ � � � � � � • - � •
AREACODE/PHONE NUMB I.D.NUMBER('�fapplica6/e) � For O�cial Use Only
``�-��.�--��� � � ��� � �� Repo�No.
; ���� No.of Pages
1. Contribution(s} Received
DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR lF AN INDIVIDUAL, qMOUNT
RECEIVED {IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE � ENTER OCCUPATION AND EMPLOYER RECEIVED
(IF SELF•EMPLOYED,ENFER NAME OF BUSINESS)
���l.�di,,C ��
� �{�. "�� ❑ .�.�..L. %
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 — lndividuai
COM— Recipient Committee(other than PTY or SCC)
OTH — Other(e.g.,businsss entity)
PTY - Political Party
Reason forAmendment: SCC — Small Contributor Committee
FPPC Form 497(Jul/2Q16)
FPPC Advice:advice@fppc.ca.gov(8b6/275-3772�
www.fppc.ca.gov