CA Form 497 Contribution Report - George Lewis 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date Stamp CALIFORNIA 497
`' ✓ FORM
(��iI it. L(�v- This Filing i U-
AREA CODE/PI LONE NUMBER I.D.NUMBER(if appbc:abtu) RECEIVED
. �, -�.}— r ���� ��� 7 �+ � �� Report No. OF RANCHO PALOS VERDESFot-Official Use Only
701 7 �1 ( CITY A
STREET ADDRESS
Amendment OCT 10 2024
C Lt r /.4 c,44 A iv-2A_C
to Report No.
CITY STATE ZIP(.;ODE (explain below)
R V CA. 7 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)NUMNEFR) CODE' (IF SELF-EMPLOYED INTER NAME OF BUSINESS) RECEIVED
C i ki) /44A0.JA A ® IND
❑ COM
gpv.) (Ci 1 7 k/1/1-. 1.,\Mi)A- ❑Check if Loan
1/ ❑ PTY ;
i1,C Vo C.e_-
SCC
G-.iv;, 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