HomeMy WebLinkAboutBFLAG FORM 497(1) Late Contribution Report Type or print In ink.
p Amounts may be rounded to whole dollars.
LATE CONTRIBUTION REPORT
AREA CODE/PHONE NUMBER
CITY
Late Contribution(s) Made
64 (�
I.D.NUMBER(YanpixaNe)
sZI `lS�
Date of
This Filing )
Report No.
E]Amendment
to Report No. _
(explain below)
No. of Pages
OCT 29 AM 10: 24
of -_... .,11 f CI-E
DATE
MADE
FULL NAME.STREET ADDRESS AND ZIP CODE OF RECIPIENT
IF COw.n7EE,ALSO ENTER LO.NUMBER)
CANDIDATE AND OFFICE
MEASURE AND JURISDICTION
AMOUNT OF
CONTRIBUTION
DATE OF ELECTION
(IF APPLICABLE)
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c+s,�ng
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Reason for Amendment:
FPPC Form 497 (Jan/03)
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