HomeMy WebLinkAboutDEAN 497 11/13/17Type or prim in ink.
497 Contribution Report Amounts may bemantled to whole dollars. 497 CONTRIBUTION REPORT
NAME OF FILE Date of Dale Stamp
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( �4'a0 r03 Report No. ") �,
❑Amendment
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to Report No.
No. of Pages
1- Contribution(s) Received
DATE
FULLNAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL.
ENTER OCCUPATIONAAME
AMOUNT
RECEIVED
(IFCOMMITTEE. ALSO ENTER m NUMeERI
CODE
OF
(IF SELF EMPLOYED ENTER NAME OF BVSINE551
RECEIVED
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❑Check if Loan
❑ PTY
❑ SCC
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❑ IND
D COM
D OTH
❑ Check if Loan
D PTY
D SCC
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Provide In)eresL reLe
D IND
D COM
D OTH
❑ Check if Loan
D PTY
D SCC
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Reason for Amendment.
^Contributor Codes
IND - Individual
COM- Recipient CommBtse(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 Helpline: 888 /ASK -FPPC (8881275 -3772)
Type or prim in ink.
497 Contribution Report Amounts may be rounded to whole dollars.
497 CONTRIBUTION REPORT
pvN�A&O. F FILE w.a w,r [ W N Date of I ) �I Date Slamp
J I •� flY—i �� �i41tS 4".•",� t u I'o This Filing
AREA CO(DEIPHONE NUMBER 10 NUMBER n1sepaeown) / Or a Se BY
( j-,- IL�.ua (03 Report No. 1
STREETADDRESS ❑ Amendment
?,) to Report No.
CITY
% No. of Pages Z
2. Contribution(s) Made
CANDIDATE AND OFFICE
DATE FULL NAME, STREETADDRESS AND ZIP CODE OF RECIPIENT OR AMOUNTOF DATE OF ELECTION
MADE (IF CanMITTee, ALSO ENTER I D NUMEEE) M EASURE AND JURISDICTION CONTRIBUTION IIPAPPLICABLE)
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Reason for Amendment.
FPPC Form 497 (March/201i)
FPPC Toll -Free Nelpline: 866/ASK -FPPC (866/276 -3772)
Reason for Amendment.
FPPC Form 497 (March/201i)
FPPC Toll -Free Nelpline: 866/ASK -FPPC (866/276 -3772)