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CA Form 497 Contribution Report No. 2 - Jerry Duhovic Ort Type or print in ink. 497 Contribution Report Amounts may be rounded to whole dollars. 497 CONTRIBUTION REPORT NAME OF FILER Date of Date StampCALIFORNIA 497 JerryDuhovic for RPV CityCouncil 2015 This Filing10/20/15 RECEIVED FORM AREA CODE/PHONE NUMBER I.D.NUMBER(if applicable) CITY OF RANCHO PALOS 2 Report No. or Official Use Only ( 1340074 OCT 2 0 2015 STREET ADDRESS 0 Amendment to Report No. CITY STATE ZIP CODE (explain below) CITY CLERK'S OFFCE Rancho Palos Verdes CA 90275 No. of Pages 1. Contribution(s) Received DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, AMOUNT RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * ENTER OCCUPATION AND EMPLOYER RECEIVED (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) Rosanne Duhovic IND $1921.50 10/19/15 111 COM N/A Rancho Palos Verdes, CA 90275 ❑ OTH ❑ Check if Loan ❑ 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) PTY—Political Party Reason for Amendment: SCC—Small Contributor Committee FPPC Form 497 (November/07) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)