Loading...
HomeMy WebLinkAboutForm 497- Greg Brockbank for City Council 2013 (2013-10-28)W (S:) (S) C\4 r - Tr U-) r--4 C\4 C14 00 C\4 CD C-4 Late Co ntribution R6port 4 yp,<, or p ri nt in i nk- Amounts may be rounded to whcAe dollws_ NAME OF FILER �3 Date'of ThisFifinq ILA �(q Q 0 'K, M Q rL WY2 AREA CODEPHOt� NUMBER LO, NlJME3FR (dapoVooW ReportNo. ------------ STREET ADVIRESS Amendment to Report No. ca -Y S TATE 'ZIPGOE)E hex pWLI be4o* q0 No. 'of P:3 ges Late C ontri b ub o n (s) Receive d • GATE RECEIVIED FULL NAME, STREET ADDRESS AND ZIP COM OF CONTRIBUTOR W COMn-MF- A= ENTER I.D. WAVM CONTIRI�LITORIF CODE A24 INDMDUAt, ENTER OCCUPATI10N AND EMPLOYER (if: SELF-EMPLOYML ENTER NAME -CF BUSWESS AMOUNT RECEIVED Oca tas kr�rr IND �Com I SOJ OTH L14►q_:3 9 PTY El SCC E] Gbeck f Loan -oc t,4 IND © COM 7 Ty .1 CA �qlfl PTY SCC �Check if Loan E] -IND F1 COM �ontrbutor Codes D - irtdWual PTY - powcal Pally DM - Cie ciperil Cmmhee (Aer than FTY car SCC} SCC - Smag ContAar Commd 17H - Offw Reason for Amendment: OTFt F� PTY El scc j 0 Check if Loan FPPC Form 497 �JatifH) FPPC Toll -Free Helpline: 8,66fASK-FPPC 8661275-3772