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Keen, Tori - 497 Form 082624
497 Contribution Report Amounts may be rounded to whole dollars. 497 CONTRIRUTION REPORT NAME OF FILER Tori Keen for Atascadero City Council 2029 Date of This Filing 08/26/2024 Date Stamp �""FrEIVED . AREA CODE/PHONE NUMBER I.D. NUMBER (ifappiicabie) !ForOfficial Use Only ar K Report No. 08262024-1 Teacher Atascadero Unified School 1,000.00 1970439 AUG � 6 2024 District STREET ADDRESS � ❑ OTH ❑ Amendment ❑ PTY to Report No. OF AT A5C�(�pER CITY STATE ZIP CODE (explain below) CLERKS OFFICE i Provide interest rate No. of Pages 1 1. Contribution(s) Received DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMIT -TEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED 08/23/2024 ar K © IND Teacher Atascadero Unified School 1,000.00 ❑ COM District ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC i Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC r Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC i Provide interest rate Reason for Amendment: `Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC—Small Contributor Committee FPPC Form 497 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov