HomeMy WebLinkAboutMERRILL 497 5/9/16I
497 Contribution Report
1
Type or print In Ink.
Amounts may be Rounded to whole dollars.
117CxR jw- Foe /)'l+yoR 2o /b --d
AREA
1 1 383+1 5-9
Date of 9 /b
This Filing
Report No. 0 0 S
❑Amendment
to Report No.
(erpleln Below) /
No. of Pages
16 MAY -9 AM 8: 4
Mi(,I I[i.0 II I Y CI.
1
497 CONTRIBUTION REPORT
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF so ENTER I. D. NUMBER)
U
CONTRIBUTOR
CODE
IF AN INDIVIDUAL,
ENTER IF AND EMPLOYER
(IF SEIF£NFLDYEn, ENI£R NAME OF BUSINESS)
MOUNT
RECEIVED
51416
)WP JIYF/L
Cf1Rr5V,4N MEO/ChL SE- AVICES
❑ IND
❑ com
,�-/
E OTH
❑ PTY
❑ scc
$6000
�/
& Check R Loan
"
P.d. nen al Rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑Check if Loan
❑ PTV
❑ SCC
Pmnae rprml Rate
Reason for
"Contributor Codes
IND - Individual
COM- Recipient Committee (other than PTY or SCC)
OTH- Other (e.g., busirwss entity)
PTY - Political Party
SCC - Smell Contributor Committee
FPPC Form 07 (MerchI2011)
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