497 Contribution Report - Contributions received 08-21-24497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER
C'I'� Gym G�:� Lam/ t y L— �—c'
Date of
This Filing b b
Report No.
❑ Amendment
to Report No_
Date Stamp
.
_
For Official Use Only
AREA CODEIIP ONE NUMBER
I.D. NUMBER (if app)rcabda)
/ "46 ?44-3 Y_
STREETADDRESS
(explain below)
No. of Pages
CITY STATE ZIP CODE
C L .? r-r G% l r-t)-1
1. Contribution(s) Received
IF AN INDIVIDUAL,
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE'
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
�y
�
IND
0 COM
!
OTH
❑ O
��77��,{�
6O-�'K7 /�'-'
❑Check ifLaan
t
Alo
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)
OTH - Other (e.g., business entity)
Reason for Amendment: PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 497 (Feb/2019)
FPPC Advice: advice@fppc.ca.gov (8"/275-3772)
www.fppc.ca.gov