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CA Form 497 Contribution Report No. 3 - Greg Royston497 Contribution Report Type or print in ink. p Amounts may be rounded to whole dollars. 497 CONTRIBUTION REPORT NAME OF FILER Date of 10/2/15 Date Stamp A 0 - , • Gregory T. Royston - Royston for Rancho Palos Verdes City Council 2015 This FilingREC EIVED • AREA CODE/PHONE NUMBER I.D. NUMBER (if applicable) 3 f OF RANCHO PALOS cia Use Only 1378542 Report No. �' STREETADDRESS ❑Amendment OCT O 2 2015 to Report No. CITY STATE ZIP CODE (explain below) 1 Rolling Hills Estates CA 902764 No. of Pages ITY CLERKS O 1. Contribution(s) Received DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED Sean O'Shea ©I N D real estate agent - broker is BRC 10/2/15 Advisors, Inc. 500.00 Santa Monica, CA 90403 El COM ❑ OTH ❑Check if Loan ❑ PTY ❑ SCC Provide interest rate Carl Dickerson © IND insurance broker - Dickerson 10/2/15 El COM p y Em to ee Benefits 1000.00 Los Angeles, CA 90039 ❑ OTH ❑Check if Loan ❑ PTY ❑ SCC % Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCc % Provide interest rate Reason for Amendment: "Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 497 (March/2011) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)