Loading...
Form 497- Yes on Measure D (2016-05-20)497 Contribution Report Amounts may be rounded to whole dollars. NAME OF FILER Date of a a IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Committee to Support San Rafael Libraries - Yes on Measure D This Filing 5/20/2016 6oClalOnly D •AREA 1,e CODE/PHONE NUMBER I.D. NUMBER (Wapplicable) 415-446-4222 1383895 Report No. MAY 2 0 201 STREETADDRESS ❑ Amendment i 1000 Fourth Street, Suite 600 Report No. (exex plain below) CITY CLERK'S 0 FICE CITY STATE ZIP CODE ❑ IND San Rafael CA 94901 No. of Pages 1 1. Contribution(s) Received DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I D NUMBER) CONTRIBUTOR CODE ' IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED 5/20/2016 Gary O. Phillips San Rafael, CA 94901 ❑x IND ❑ COM ❑ OTH Mayor City of San Rafael 1,200 E] Check if Loan ❑ PTY ❑ SCC i Provide interest rale ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC i Provide interest rate Reason for Amendment: "Contributor Codes IND — Individual 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