CA Form 497 Contribution Report - George Lewis 497 Contribution Report Amounts may be rounded to whole dollars.
NAML OF FILER Date of Date Stamp CALIFORNIA 497
f-vL C ();' (--c.)m./,it. This Filing 7U`��' FORM
AREA CODE/PI LONE NUMBER I.D.NUMBER of apple abtu) RECEIVED
_ � 7.� r 0-'1I t j -1 L+ � Report No. RANCHO Fot-Official Use Only
701 7 11 I CITY OFPALOS VERDES
STREET ADDRESS
Report No.
CITY STATE ZIP CODE (explain below)
RPV cA. v2 7_'j No. of Pages CITY CLERK'S OFFICE
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 t)NuMOEFR( CODE' (IF SELF-EMPLOYED ENTER NAME OF BUSINESS) RECEIVED
GJ '; 4�i I Ntj j'eA(iiATA ® IND '
❑ COM
• ❑ OTH �Z..�� N1 �}i' ❑Check if Loan
L • PTY
( 'nhcvo
• SCC
G-.J'i4;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