HomeMy WebLinkAboutForm 497 Heather Newsom 103118497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER n (
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Date of
Filing rt6
Date Stamp
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W -CLI` ED lorOfWficialUse
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AREA DElPHONE NUMBER
LD. NUMBER (;reP��bra)
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E] Check if Loan
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Report No.
❑ PTY
❑Amendment
} n
OCT
VLI 3 1 2018
STIR ETADDRESS
CITY STATE ZIP CODE
to Report No.
(explain below)
CITY OF- ATASCADC O
Ala r /1 Q�� � q� _W'No.
of Pages f
CITY CLERK'S OH-! �
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE*
IF AN INDIVIDUAL,
( ENTER OCCUPATION AND EMPLOYER
IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
AMOUNT
RECEIVED
' b %3v %1 $
r,,r d s
`?i1 �o Ida
D
coM
❑ OTH
�� o a 3
E] Check if Loan
l 1
❑ PTY
SC'C�G (60- 1? �3 ��
Elscc
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
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/2015)
FPPC Advice: advice@fppc.ca.gov (855/275-3772)
www.fppc.ca.gov
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