HomeMy WebLinkAboutForm 497 - Rachel Kertz for Board of Education 2018 (2018-09-19)497 Contribution Report Amounts may be rounded to whole dollars.
497 cortTRlstmoN REPORT
NAME OF FILER Date of DaleStarrip is ' f
E C IEQ V LL5�
Rachel Kertz for Board of Education 2018 This Filing 09/29/201 � V O'Liji
i
AREA CODOPHONE NUMBER I. D. NUMBER (AaiwkeW) For Official Use Only
Report No. 091-92018-1
( 1410420
STREET ADDRESS SEP 2 �
[] Amendment
to Report No.
CITY STATE 7JPCODE {explainhelrnw} 1 IlY CLERK'S OFFI E-
1.
of Pages
Roseville CA 95661
1. Contributions) Received
DATE
FULL NAME, STREET ADDRESS AND ZCP CODE OF CONTRIBUTOR
CCNTRIBUTOR
IF AN INDIVIDUAL,
ENrER OCCUPATIONAND EMPLOYER
AMOUNT
RECEIVED
ilFCoraralrrEE �tssEtRexl.O.raa.+3Er;+
,
CODE
OF`ELF-EMPLOYED, ENTIERNAMEOFBUSINESS}
RECEIVED
09/11/2018
Rachel Kertz
IND
Candidate
206.16
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
SCC
Provide Interest rate
09/19/2016
Rachel Kertz
Candidate
3,500.00
1—I CCI
❑ OTH
p Check if Loan
❑ PTS'
❑ SCC
Provide Interest rate
❑ ICED
❑ coni
❑ OTH
Q Check if Loan
❑ PTY
❑ SCC
Provide interest rate
Reason for Amendment:
www.netfile.com
—I
I
Q
00
`Contributor Codes O
IND -Individual O
COM - Red pterntCommittee (other than PTYorSCC)
OTH - Other (e.g., business entity) o
PTY -Political Party o
SCC -Small Contributor Committee
I
O
FPPC Form 497 (Jan12016) CO
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppr-ca.gov