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CA Form 497 Contribution Report No. 3 - Jerry Duhovic 497 Contribution Report Type or print in ink. p Amounts may be rounded to whole dollars. 497 CONTRIBUTION REPORT NAME OF FILER Date of Date Stamp CALIFORNIA 497 JerryDuhovic for RPV CityCouncil 2015 This Filing 10/22/15 FORM AREA CODE/PHONE NUMBER I.D.NUMBER(if applicable) or•'icia Ise •n y ( 1340074 3Report No. RECEIVED STREET ADDRESS CITY OF RANCHO PALOS VEP's ES 0 Amendment to Report No. OCT 2 2 2015 CITY STATE ZIP CODE (explain below) No.of Pages 1 Rancho Palos Verdes CA 90275 1. Contribution(s) Received GITYCLERKSOFFI E DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF P INDIVIDUAL, AMOUNT RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * ENTER OCCUUPATION AND EMPLOYER RECEIVED (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) 10/21/15 Rosanne Duhovic X❑ IND $1008 ❑ COM N/A Rancho Palos Verdes, CA 90275 ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH 0 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(March/2011) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)