CA Form 497 Contribution Report No. 4 - Ken Dyda 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date Stamp CALIFORNIA 497
DIDA 1-0(4_ APU )-(71 ci This Filing l ) ~/ -/ kECE
F ORM
AREA CODE/PHONE NUMBER I.D.NUMBER(if applicable) \-:,;i-TY OF RANCHO "' • Y Ise Only
( 01 30'a. 7Zll+ 95 Report No.
STREET ADDRESS OCT 1 5 2019
3Ds60 ❑Amendment
-���� ,� D/Lto Report No.
CITY STATE ZIP CODE (explain below)
l4,Vc,jj j ,, utrywu r " �- No. of Pages
7.. "Y CLERK'S OFFIC._
Vi
1. Contribution(s) Received
IF AN INDIVIDUAL,
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATION AND EMPLOYER AMOUNT
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE* (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) RECEIVED
t o
-f
OO/) IND
El COM 1 ' TI 2c O
J
cit fids IJ �' 44 , ❑ OTH
6-1116- inCheck if Loan
gA_Aj • t P6- (CJS u fid g02-), 0 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
*Contributor Codes
IND - Individual
COM - Recipient Committee(other than PTY or SCC)
OTH - Other(e.g., business entity)
Reason for Amendment: 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