HomeMy WebLinkAboutForm 497 Roberta Fonzi 103108497 Contribution Report
NAME OF FILER
AREA CODEIPHONE NUMBER I.D. NUMBER (ifappicable)
)3C)�5)
1c�
10
,rT T
1 Contribution(s) Received
Type or print in ink.
Amounts may be rounded to whole dollars. 497 CONTRIBUTION REPORT
Date of
Date Stamp e - , 0
_
This Filing + e
RECEIVENr For Official Use Only
STATE ZIP CODE
Report No. '
OCT 31
❑ Amendment
to Report No.
(explain below) CITY OF ATASI
No. of Pages CITY CLERKS
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
OF COMMITTEE, ALSO ENTER IA. NUMBER)
CONTRIBUTOR
CODE
IF AN INDIVIDUAL, AMOUNT
ENTER OCCUPATION AND EMPLOYER RECEIVED
OF SELF.EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
IND
��'�P:2
COM
��OTH Check if Loan
' �� , O�
❑ PTY
1 x'
❑ SCC
i f �'-
Provide interest rate
tR�IND
❑ COM
�`—
,3/_Q
❑ OTH
❑PTY
��2� Check if Loan
❑ SCC
I-� y�''� Provide interest rate
❑ IND
❑ COM
❑ OTH
Q Check if Loan
❑ PTY
❑ SCC
%
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 (November/07)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)