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497 Contribution Report
Amounts may be rounded t0wb0e dollars.
IF AN INDIVIDUAL,
DATE FULL NAME ST REET ADDRESS AND ZIP CODE Cr- CONTRIBUTOR
CONTRIBUTOR
ENTER OCCUPATIONnANDD EaMPLOYES
AM
RECEIVED FA. E. 90 JtFi'S.xI;N5EA:
497 COMRIBUTION REPIX3T
NAMEOFFILER
R=C ENED
RIVE
De[e 0'
Dale Stamp
2,5[0.00
'Y.' 2)36
❑ iyU
rbie Filing 11�- 4/2016 _
(6 NOY —4 k9�
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❑ DOM
AREA CODENHONE NURSER
ID. NUMBER ANws-r -"
OTH
Report No.1114ll -1
❑ PTV
(
1]ai01_5_
P—. Internal tale
11/e3/291e :Ptnsocia 6 eEeamti¢cera Lora= 450 PAC S"
❑ Amendment
2.5c0 _10
771
STREETADDRESS
to Report No.
14en{Yan Oebwl
LJ CO.4
CRY STATE 2FCODE
____ .. -
• - �
Not of Pages 1
❑ OTH
1. Contribution(s) Received
Reason far Amendment
A
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s
U
F
www.netfile.com
'COninh eCOdee
wD- InUlndD
CO'A - ReC:pienl Committee [,other than PTY or SCC)
O H - Other Ie g.. 9aeineas entity)
PTY- Pclitical Pally
' -'_— -- SCC -Smaa COntnO�lor CUmmlltec
FPPC Form 497 (Jan12016)
FPPC Advice: adNoe@fppaa.gw (866y2M3772)
www.fppc.ca.gov
IF AN INDIVIDUAL,
DATE FULL NAME ST REET ADDRESS AND ZIP CODE Cr- CONTRIBUTOR
CONTRIBUTOR
ENTER OCCUPATIONnANDD EaMPLOYES
AM
RECEIVED FA. E. 90 JtFi'S.xI;N5EA:
CODE
R=C ENED
RIVE
1110i /2016 Ch on PoL y Go puEl Atfaars
6P.d
2,5[0.00
.
❑ iyU
❑ DOM
OTH
❑ Check If Loan
❑ PTV
❑ SCC
P—. Internal tale
11/e3/291e :Ptnsocia 6 eEeamti¢cera Lora= 450 PAC S"
2.5c0 _10
❑ IND
LJ CO.4
Cortunittee lit T2ao26]
❑ OTH
❑ Check if Loan
❑ PTV
SCC
F:I de lek.N uU.
I
❑ IND
U COM
E] Check 0 Loan
V
PTY
SCC
P—se nPuril dale
Reason far Amendment
A
m
s
U
F
www.netfile.com
'COninh eCOdee
wD- InUlndD
CO'A - ReC:pienl Committee [,other than PTY or SCC)
O H - Other Ie g.. 9aeineas entity)
PTY- Pclitical Pally
' -'_— -- SCC -Smaa COntnO�lor CUmmlltec
FPPC Form 497 (Jan12016)
FPPC Advice: adNoe@fppaa.gw (866y2M3772)
www.fppc.ca.gov