CA Form 497 Contribution Report No. 1 - John Cruikshank 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date t �El` ,i CALIFORNIA 497
John Cruikshank for Rancho Palos Verdes City Council 2017 This Filing 9/18/17 V FORM
AREACODE/PHONE NUMBER I.D.NUMBER(depplcade) 1 CRY OF RANCHO P or•=cIa Ise-•n
424-772-8648 1394475 Report No.
STREET ADDRESS - SEP 18 2011
Amendment
to Report No.
CITY STATE ZIP CODE (explain below)
Rancho Palos Verdes CA 90275 No.of Pages 1 CITY CLERK'S OFFICE
1. Contribution(s) Received
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUALAMOUNT
ENTER OCCUPATION AND EMPLOYER
RECEIVED (IF COMMITTEE.TEE.ALSO ENTER ID.NUMBER) CODE* (IF SELF-EMPLOYED.ENTER NAME OF BUSINESS) RECEIVED
Lawrence C. Baker Jr., Rancho Palos Retired
❑X IND
Verdes, CA'90275 ❑ COM 1,000.00
9/17/17
❑ OTH D Check if Loan
❑ PTY
❑ SCC - %
Provide interest rate
❑ IND
❑ COM
❑ OTH ❑Check if Loan
❑ PlY
❑ SCC %
Provide interest rate
❑ IND
❑ COM
• ❑ OTH ❑Check if Loan
❑ PTY
❑ SCC %
Provide interest rate
"Contributor Codes
IND — Individual
COM— Recipient Committee(other than PlY or SCC)
OTH — Other(e.g.,business entity)
PlY — Political Party
Reason for Amendment: SCC— Small Contributor Committee
FPPC Form 497(Jul/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov