CA Form 497 Contribution Report No. 4 - Krista Johnson 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date Stamp CALIFORNIA 497
_Krista Johnson for RPV City Council 2017 This Filing 10/26/2017 RECEIVED FORM
AREA CODE/PHONE NUMBER I.D.NUMBER ofappicante) CITY OF RANCHO PALOS\ - r .'a j'cla se fan y
310 508-3201 1398133 Report No.
STREET ADDRESS OCT 2 7
2011
0 Amendment t�
to Report No.
CITY STATE ZIP CODE (explain below) CITY CLERK'S OFFICERancho 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,
RECEIVED IIF COMMITTEE,ALSO ENTER V.D.NUMBER} ENTER OCCUPATION AND EMPLOYER AMOUNT
CODE (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) RECEIVED
Krista Johnson
® IND Self Employed 5,000.00
10/26/2017 D CoM Starrock Business
Rancho Palos Verdes, CA 90275 D OTH Financial Services ci Check if Loan
° P'ry 0.00
❑ scc
Provide interest rate
❑ IND
❑ COM
❑
OTH 0 Check if Loan
❑ PTY
❑ scc
Provide interest rate
❑ IND
❑ COM
❑ OTH 0 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(3ul/2015)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov