HomeMy WebLinkAboutForm 497 - Revitalize San Rafael Library and Community Centers - Yes on P; 09-16-24497 Contribution Report
Amounts may be rounded to whole dollars.
NAM.= OF FILER
Revitalize San Rafael Libraries & Community Center - Yes on P
AREA CODE/PHONE NUMBER I.D. NUMBER (Ilappllcable)
1467556
STREET ADDRESS
CITY STATE ZIP COD-
San Rafael CA 94912
1. Contribution(s) Received
Date of 9/16/2024
This Filing
Report No. 103
Amendment
to Report No. _
(explain below)
1
No. of Pages —
S E P 1 5 �n4
CLERK'S i
For Official Use Only
IF AN INDIVIDUAL,
DATE
L-L NAME-, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
N R OCCUPATIO'� AND E.M. a`_OY=R
NT
AMOUNT
RECEIVED
(i= COMMITTEE, ALSO ENTER'.D. NUMBER)
CODE`
(r S_! EMPLOYED. ENTER NAME OF 3US'NESS)
RECEIVED
Paula & Mark Kamena
Z IND
Retired
1000
❑ COM
9/16/2024
❑ OTH
❑ Check if Loan
San Rafael, CA 94901
❑ PTY
❑SCC
%
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Provide interest rase
❑ IND
❑ COM
❑ OTH
❑ Check if Loan.
❑ PTY
❑ SCC
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(Feb/2019)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov