HomeMy WebLinkAboutMERRILL 497 05/13/16f)
497 Contribution Report
f)
Typo or print In Ink
Amounts may he rmmad ts whole dollop.
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487 CONTRIBlIMON REPORT
NANB OF NLER
MERRIL leac
De o �
Filing
a Stamp
g
AMOUNT
RECEIVED
007 (
MAY 13 PM 3105
or Offical Use Only
M CODE ENUMBER
I.D. NUMBER(NAWA )
!38345-9
Report
BA
❑ Re o Report No.
to Repoli No.
(fines )
No. of Peg"
Ei%i[ IGLU CII Y CLFft
CITY STATE ZIP CODE
1. Contribution(s) Received
DATE
RECDVED
FULL NAME, BTNEEf ADDRESS AN0 ZIP CODE OF CONTRIBUTOR
VFCaMMne .IMOml.o.N.MaeR)
CONTRIBUTOR
CODE
IF AN INWDUAL,
EN IF
weFisers�mw,ermnuwe of wexaeel
AMOUNT
RECEIVED
S 3 i
��
P
CVMrL'�
GNP.�t571 ?�' MF'D�G1G SE+w��oS
❑ ]NO
❑ COM
[5'/OTH
❑PTY
Cl SCC
C4tiheek K Loan
0 e
vrwxN Ma.N nw
❑ IND
❑ COM
❑ OTH
❑ Check M Loan
❑ PTY
❑ SCC
z
PnMM IMemr ieN
❑ IND
❑ COM
❑ OTH
❑ Check p loan
❑ PTY
❑ SCC
"
PNVW Meets Tent
Reason forAmere men0
"Conblbutor Coda
IND - Indlrldual
COM- Reciplant Committee (other then PTY or SOD)
OTH - Other (e.g.. buebwae anbty)
PTY - Pdlgoal Party
SOC - Small CDntdbuW Cornmeal
FPPC Form 497 (March/2011)
FPPC Toiliree Kelpline: BWABK•FPPC (860127"772)