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497 Contribution Report
..eff 7kac for city counn it 2016
;
1. Contribution(s) Received
Amounts may be founded to whole donuts.
Date of
This Filing 10 /lap ols_
Report
❑ Amendment
to Report No.
W14Aanbabwi
No. of Pages 1
OCT 17 PM 3:
KE:rtiiI'— -Ii1,
Reason for Amendment.
1vww.netffle.com,
'COnlabutor Codes
IND - Individual
COM - R,,nAft COmTrnee (.ther Plan PTY or SCC)
O 1 H - Other le.g_ business army)
PTV - POlificnl Party
ROD -Smarr Contnbal0, Cur',"tee
FPPD Form 497 (Jan @016)
FPPC Advice: adwce@fppcn.gm, (86612/53772(
www.fppc.na.goe
IF AN INDIVIOuAI.,
DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
ENTER OCCUPATIONANDEMPLOYER
AMOUNT
RECEIVED FCWM E kSn!Xivitn.M.M6eT.,
CODE
gfEM IDVEGE IE re OF WS'tiE5S1
RcCENED
10/1]/2616 - nanrel By
117420
COM�
❑ OTH
❑ Check If Loan
PTY
❑^
$CG'
Y
Inlemsi rsle
LJ
30/1T/2916 Fat[3Ck Nade
�I
Sultan - ...'
C' COM
❑ OTH
Cl Check if Loan
❑ PTV
❑ $CC
Pmvma'inleren refs
❑ IND
❑ COM
[] OTH
❑ Checklf Loan
L] PTY
❑ SCC
TeI PmuiDe mlxreal el
Reason for Amendment.
1vww.netffle.com,
'COnlabutor Codes
IND - Individual
COM - R,,nAft COmTrnee (.ther Plan PTY or SCC)
O 1 H - Other le.g_ business army)
PTV - POlificnl Party
ROD -Smarr Contnbal0, Cur',"tee
FPPD Form 497 (Jan @016)
FPPC Advice: adwce@fppcn.gm, (86612/53772(
www.fppc.na.goe