CA Form 497 Contribution Report No. 2 - Ken Dyda 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date Stamp CALIFORNIA
by ' 497
. I2 P1/ C t RJti1 L S This Filing s �' (� FORM
AREA CODE/PHONE NUMBER I.D.NUMBER(if applicable) CITY OF RANCHO PAI.I, V � T-„'ial Use Only
9 Di -so?./ Report No. --
STREET ADDRESS SEP 2 7 209
❑Amendment
, to Report No. •
CITY STATE ZIP CODE (explain below) CITY CLERK'S OFFICE
N.)(-440 PActo3 U Ab C 5, ON a 27S No. of Pages
1. Contribution(s) Received
IF AN INDIVIDUAL,
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATION AND EMPLOYER AMOUNT
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE* (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) RECEIVED
Or1 - ��- 19
RAN CAi1 P�IA S U(ci>c S C'.Q1 Le 4,1 e.1Ls. i'A ❑ IND g �j No
w•ram. COM
s Po Ais J o �.� W Jucr- Po,,v,_ 0 k=141(-or,k.e-•vi U,C ❑ OTH
Ol 6� v s 1 Q t 4131� CI Check if Loan
`] 1 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)
Reason for Amendment: PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 497(Feb/2019)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov