CA Form 497 Contribution Report Amendment to Report No. 2 - Susan Brooks 497 Contribution Report Type or print in Ink.
Amounts may be rounded to whole dollars.
497 CONTRIBUTION REPORT
NAME OF FILER Date Stamp .
Date of ,,' R ,
f
Susan Brooks for RPV City Council 2015 This Filing ` RECEIVED ' : ,
u:' '
AREA CODE+PNONENUMBER I D.NUMBER(d, .'ie
, 'i�bfe) C OF RANCHO PALOS • 0 ",c di ase t l
�y
Report No.
1378846
STREET ADDRESS SEP 11 2015
jg Amendment
to Report No.
CITY STATE ZIP CODE (explain below)
Rancho Palos Verdes CA 90275 No.of Pages
CITY CLERK'S 0-FICE
1. Contribution(s) Received
DATE I FULL NAME.STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. AMOUNT
RECEIVED OF cOMMtrrEE.ALSO ENTER i.o.NUENTER OCCUPATION AND EMPLOYER
CODE (IF SELF-EMPLOYED ENTER NAME OF BUSINESS) RECEIVED
/Ct e 41 itC)k eris
4_-(,4c.,7z-- air , bOO 00
coM
i
9/C1/ ,.
PTY
--- %
l� ik5--.444,7 <$ 0
SCC
`491 �
,!T f +.� QProvide interest rate
❑ IND
❑ COM
❑ OTH 0 Check if Loan
❑ PTY
❑ SCC
Provide interest rate
❑ IND
❑ COM
❑ OTH 0 Check if Loan
❑ PTV
❑ SCC
Provide interest rate
N.
e'*Contributor Codes
IND - Individual
COM- Recipient Committee(other than PTY or SCC)
0TH - Other(e.g.,business entity)
PTY - Political Party
Reason for Amendment:- -- SCC - Small Contributor Committee
�” FPPC Form 497(March/211)
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