HomeMy WebLinkAboutForm 497 - Rachel Kertz for Board of Education 2018 (2018-09-20) Amendment497 Contribution Report Amounts may be rounded to whole dollars.
497 CONTRIBUTION REPORT
NAME OF FILER
Rachel Kertz for Board of Education 2018
AREA CODE/PHONE NUMBER I.D. NUMBER (ilapplicable)
( 11410420
STREET ADDRESS
CITY STATE ZIP CODE
Roseville CA 95661
1. Contribution(s) Received
Date ofP� pp
This Filing 09/20/2018 1!
Report No. 09192018-1
&CITY
EP 2 0
MAmendment
to Report No. 09192018-1
(explain below) LERK'S OFF CE
No. of Pages —_.i__
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL,
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER I D. NUMBER)
*
CODE
ENTER OCCUPATION AND EMPLOYER
RECEIVED
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
09/11/2018
Rachel Kertz
Director of Strategic Programs
206.16
❑ COM
Foundation
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
i
Provide Interest rate
09/19/2018
Rachel Kertz
Dire tor of Strategic Programs
3,500.00
❑ COM
Foundation
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
i
Provide Interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
y
Provide interest rate
`Contributor Codes
IND -Individual
COM - Recipient Committee (other than PTY or SCC)
OTH - Other (e.g., business entity)
Reason for Amendment: Amend Occ_ upation and Employer PTY - Political Party
SCC -- Small Contributor Committee
FPPC Form 497 (Jan/2016)
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