HomeMy WebLinkAbout497 Late Contribution Type or Print in Ink
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Report to whole dollars. Date Stamp "s'r i�A
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Filer Must Check Applicable Box: Co A for Official Use Only
Part: NOV Ol 1996
A Reporting Late Contribution(s) Received: l
❑ Reporting Late Contribution(s) Made: II CITY CLERKS PT
NAME Of FILER STREET ADDRESS
AREA CODFPHONE NUMBER I.D. NUMBER (if applicable) CITY STATE ZIPCODE
Late Contribution(s) Received From: 11 Late Contribution(s) Made To :
NAME �f. � LD. NUMBER (i /ap011<able) NAME OF CANDIDATE OR COMMITTEE: ID. NUMBER
ADDRESS CITY STATE ZIPCODE ADDRESS CITY STATE ZIP CODE
OCCUPATIONIEMPL OYE R OR NAME OF BUSINESS IF SELFEMPL OYEDGf appfioblel OFFICE SOUGHT BY CANDIDATE OR BALLOT NO. 4ETTER AND JURISDICTION
DATE RECEIVED AMOUNT DATE MADE: AMOUNT DATE Of EJECTION
NAME I.D NUMBER (Uappllcable) NAME OF CANDIDATE OR COMMITTEE: I.D. NUMBER
ADDRESS CITY STATE ZIPCODE ADDRESS CITY STATE ZIP CODE
• OCCUPATIONIEMPLOYER OR NAME OF BUSINESS IF SELF EMPLOYED(i(applicable) OFFICE SOUGHT BY CANDIDATE OR BALLOT NOILETTER AND JURISDICTION
DATE RECEIVED AMOUNT DATE MADE AMOUNT DATE OF ELECTION
NAME I.D. NUMBER(ifapphcable) NAME OF CANDIDATE ORCOMMITTEE: I. D. NUMBER
ADDRESS CITY STATE ZIPCODE ADDRESS CITY STATE ZIP CODE
OCCUPATION EMPLOYER OR NAME OF BUSINESS IF SELF EMPLOYED(If appb(able) OFFICE SOUGHT BY CANDIDATE OR BALLOT NO 4ETTER AND JURISDICTION
DATE RECEIVED AMOUNT DATE MADE: AMOUNT DATE OF ELECTION
f OH IMF ONMAHON R[ DUINED i0 BC PROVIDED i0 VOU PIINSl1FNT f U SIZE INF DRIAAi1DN PNACi1CF5 4Ci OF 1937, Sit 1 POLITICAL REFORM ACT
State of California Fair Political Practices Commission