HomeMy WebLinkAboutForm 497- Yes on Measure D (2016-05-23)497 Contribution Report
NAME OF FILER
Committee to Support San Rafael Libraries - Yes on Measure D
AREACODE/PHONE NUMBER I.D. NUMBER (Wapplica6/e)
415-446-4222 11383895
1000 Fourth Street, Suite 600
CITY
San Rafael
1. Contribution(s) Received
Amounts may be rounded to whole dollars.
STATE ZIP CODE
CA 94901
Date of 5/23/2016
This Filing
7
Report No.
❑ Amendment
to Report No.
(explain below)
No. of Pages 1
MAY 2 3 2016
ITY CLERK'S OFFI
DATE
FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
WAN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
San Rafael Police Association Political Action Committee
❑ IND
1,000
910 D Street
❑X COM
5/21/2016
San Rafael, CA 94901
❑ OTH
❑ Check if Loan
FPPC# 831553
❑ PTY
❑ SCC
%
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
%
Provide interest rate
❑ 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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov