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CA Form 497 Contribution Report No. 1 - Susan Brooks
Late Contribution Report NAME OF FILER Susan Brooks for RPV City Council 2015 AREA CODE/PHONE NUMBER I.D. NUMBER (ftAptic") 1378646 STREET ADDRESS CITY STATE Rancho Palos Verdes CA Late Contribution(s) Received i Type or print in Ink. Amounts may be rounded to whole dollars. LATE CONTRIBUTION REPORT Date Sip , Date of 08/10/2015 , • This Filing ,� RECEIVE 1 OF RANCHO PALO VEf4PS'at use only Report No. C ❑ Amendment AUG 10 201 to Report No. ZIP CODE (explain below) 90275 No. of Pages 1 ITY CLERK'S O F CE DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (F coMMITTEE. ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYIED. ENTER NAME OF BUSINESS) MENAMOUNT RECEIVED ED Bill Bloomfield © IND retired 08/1012015 ❑ Com Manhattan Beach, CA 90266 ❑ OTH 1 ,400 D PTY ❑ SCC [j Check if Loan [] IND [] COM D OTH D PTY �] SCC 0 Check if Loan [] IND [] COm ❑ OTH [] PTY [] SCC 0 Check if Loan 'Contributor Cedes IND -- Individual PTY .- Political Party COM — Recipient Committee (other than PTY or SCC) SCC — Small Contributor C=Mee DTH — O#w Reason for Amendment: FPPC Form 497 (Jan/03) FPPC Toil -Free Helpline: 866/ASK-FPPC 8661275.3772 t Is