CA Form 497 Contribution Report No. 2 - Dave Emenhiser ( s,-;/.
497 Contribution Report Amounts may be rounded to whole dollars.
NAME FILERaa4/463 . i a„ .: &D- - Of Date Stamp CALIFORNIA
T,,f�Flung /D-2/4/7FORM
AREA CODE/PHONE NUMBER I.D. M IiR(if,pplicable) RECEIVED
For Official Use Onl
.5/0 a7gq- X9v0 /9/
Report No. RDES y
BEY OF RANCHO PALOS VE
❑Amendment OCT i 2019
to Report No.
CITY • STATE ZIP CODE (explain below)
,• 4 No.of PagesCLERK'S OFFIC�?`7 �Tl(
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
".----/
//, , • P/ 4 ❑ IND Pat
CMOD
M
OTH/ /,77 .
SCC
• Provide interest rate
2.,j2.....0:4016/... .)ari.4.04 ❑ IND / 9. eov
/,04,/, o,-70,L - p-COM
❑
/ , �bEl °�°
7/ 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