HomeMy WebLinkAboutForm 497- Yes on Measure D (2016-05-02)497 Contribution Report Amounts may be rounded to whole dollars.
Date of 5/2/2016 This Filing
NAME OF FILER
Committee to Support San Rafael Libraries -Yes on Measure D
Report No. 3 AREA CODE/PHONE NUMBER
415-446-4222
1.0 . NUMBER (ifapp/icab/e)
1383895
STREET ADDRESS
DAmendment
1000 Fourth Street, Suite 600 to Report No.
STATE ZIP CODE (explain below)
San Rafael CA 94901 No. of Pages 1
1. Contribution(s) Received
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR DATE
RECEIVED (IF COMMIITEE. ALSO ENTER 1.0. NUMBER) CODE *
McCullough for City Council 2015 D INO
~ COM
4/30/2016 San Rafael, CA 94901 D OTH
FPPC# 1339798 D PTY
D sec
D INO
D COM
D OTH
D PTY
D sec
D INO
D COM
D OTH
D PTY
D sec
ReasonforAmendment: __________________________________________________________________ ___
~
IF AN INDIVIDUAL,
AMOUNT ENTER OCCUPATION AND EMPLOYER
RECEIVED (IF SELF·EMPLOYED ENTER NAME OF BUSINESS)
"Contributor Codes
INO -Individual
2,500
D Check if Loan
%
Provide Interest rate
D Check if Loan
%
Provide interest ra te
D Check if Loan
%
Provide interest rate
COM -Recipient Committee (other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY -Political Party
SCC -Small Contributor Committee
FPPC Form 497 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov