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497 Soubirous (10-16-13) R
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Late Contribution Report <br />Type or print in ink. <br />Amounts <br />may be rounded to whole dollars. <br />NAME OF FILER <br />LATE CONTRIBUTION REPORT <br />Mike Soubirous for Riverside City Council - Ward 3 2013 <br />Date of <br />This Filing 10/16/2013 <br />Date Stamp <br />CALIFORNIA <br />jAREACODE11PHONE NUMBER I.D. NUMBER (if applicable) <br />RECEIVE <br />� � °�� <br />13555$1 <br />Report No. LCR- 201310 5 <br />For official Use Only <br />STREET ADDRESS <br />OCT 1 6 2013 <br />❑ Amendment <br />to Report No. <br />City Of Riverside <br />CITY STATE ZIP CODE <br />(explain below) <br />City Clerk'S Offic <br />Riverside CA <br />No. of Pages 2 <br />1 / 2 <br />Late Contribution(s) Received <br />DATE FULL NAME, MAILING ADDRESS AND ZIP E OF CONTRIBUTOR CONTRIBUTOR <br />RECEIVED G COO <br />IF AN INDIVIDUAL <br />(IF COMMITTEE, ALSO ENTER NUMBER) <br />CODE <br />ENTER OCCUPATION AND EMPLOYER AMOUNT <br />10/15/2013 LOCAL 47 IBEW POLITICAL ACTION COMMITTEE <br />(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED <br />❑ IND <br />1 <br />FRI COM <br />1500.00 <br />Diamond Bar CA <br />❑ OTH <br />0 <br />ID: 861332 <br />PTY <br />IH <br />H3 <br />'Contributor Codes <br />IND - individual PTY- Political Party <br />COM - Recipient Committee (o(her than PTY or SCC) SCC - Small Contributor Committee <br />OTH - Other <br />Reason for Amendment: <br />❑ IND <br />❑ COM <br />❑ OTH <br />❑ PTY <br />❑ SCC <br />❑ IND <br />❑ COM <br />❑ OTH <br />❑ PTY <br />❑ SCC <br />Date Stamp FPPC Form 497(June /01) <br />FPPC Toll -Free Helpline: 866 /ASK•FPPC <br />
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