CA Form 497 Contribution Report No. 5 - Ken Dyda 497 Contribution Report Amounts may be rounded to whole dollars
NAME OF FILER Date of Date Stamp CALIFORNIA 497
D £Y Fes. RP/ L I 1 f Cothk) L 15 This Filing RECEIVED FORM
AREA CODE/PHONE NUMBER I D NUMBER Of applicable)
3 r ��� 3027 X12-- ! / Report No CI OF RANCHO PAIRSR Official Use Only
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OCT 2 8 2019
0 Amendment
?,o3&(7 CASK-1 okiA 8a-_ to Report No
CITY STATE ZIP CODE (explain below)
giA. c/Ay P4 I, f ,t7 1406- C,4 t) -7S- No of Pages
CTYCLERK'SO ' FICE
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
,i'VC( 9/ L-a� V i(Zc CiA Le-14 do F(S 1-4 i P 0 IND /,
�.��1 j co AA vlet •Tr6-6- �oAi O,�'�-.-v0 io/) r ® COM
Dew t,i c;'c.-#7 (.L - 19 15 3 2-S ❑ OTH ❑Check if Loan
C/e R..ere- OptvoASc LLP ❑ PTY
S)S s . r=�C i�:>4\ s 7" -r�, lit 0 ❑ SCC opo
Lam ;Lv Sr CA 5'00 -7 I Provide interest rate
❑ IND
❑ COM
❑ OTH 0 Check if Loan
❑ PTY
❑ SCC ok
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