HomeMy WebLinkAboutForm 497 - Yes on Measure E (2013-11-05)Late Contribution Report
NAME OF FILER
Committee For A Safer San Rafael - Yes on Measure E
AREA CODE/PHONE NUMBER T1. D. NUMBER (wapplicable)
415-456-4000 1
1359556
STREET ADDRESS
1000 4th Street Suite 600
CITY
STATE
San Rafael CA
Late Contribution(s) Received
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBU
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) TOR
11/4/2013 The Permanente Medical Group
c/o KP Financial Services Ops
75 N. Fair Oaks Ave.
Pasadena, CA 91103
11/5/2013 San Rafael Firefighters PAC
P.O. Box 2519
San Rafael, CA 94912
#891308
*Contributor Codes
IND — Individual
COM — Recipient Committee (other than PTY or SCC)
OTH —Other
Reason for Amendment:
PTY — Political Party
Small Contributor Committee
W_= W
�mqjvj��
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
0
H=wq1w
AMOUNT
RECEIVED
$3,500.00
El Check if Loan
$2,459.31
n Check if Loan
FPPC Form 497 (Jan/03)
FPPC Toll -Free Helpline: 866/ASK-FPPC
8661275-3772