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497 Contribution Report Amounts may be munded to whole eollans. 497 CONTRIBUTION REPORT
NAM OF FILER ' �� Dale Stamp .
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STRETADDRESh [3 Amendment
- to Report No.
DATE
RECEIVED
FULLNAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
nr LCMNIREE. ALSO ENTER to R...Fal
CONTRIBUTOR
CODE
IF AN INDIVIDUAL.
OF �EEMFLOEID RDTR RINNE OF eVSNEM
AMOUNT
RECEIVED
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❑ IND
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L:1 COM
OTH
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❑ PTY
❑ SCC
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❑ PTV
s
❑SCC
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Reason for Amendment
- Contributor Codes
IND — Indi,adual
COM — Recipient Committee (other than PTY or SCC)
OTH— Other (e.g, business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 497 (March/2011)
FPPC Toll -Free Nelpline: 666IASK.FPPC (6661275 -3772)