HomeMy WebLinkAboutForm 497 Mark Dariz 091718497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of
Mark Dariz Committee to Elect for Atascadero City Council 2018 This Filing 9/17/18
AREA CODEIPHONE NUMBER I.D. NUMBER (it applicable) 1
1407272 Report No.
STREETADDRESS
❑Amendment
to Report No.
CITY STATE ZIP CODE (explain below)
Atascadero CA 93422 No. of Pages 1
1. Contribution(s) Received
SEP 1 7 2018
CITY OF ATASI
CITY CLERK'S
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
IF COMMITTEE, ALSO ENTER I.D. NUMBER
( )
CONTRIBUTOR
CODE *
IFAN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
AMOUNT
RECEIVED
9/16/18
Lincoln Club of San Luis Obispo County
❑ IND
ElcoM
❑ OTH
$ 1,500
❑ Check if Loan
❑ PTY
X1 SCC
%
Provide interest rate
Lincoln Club of San Luis Obispo County
❑ IND
ElcoM
$ 990
8/23/18
❑ OTH
❑ Check if Loan
❑ PTY
❑X SCC
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 (Jul/2016)
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www.fppc.ca.gov