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497 Soubirous (11-05-13) R
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Late Contribution Report <br />Type or print in ink. <br />Amounts may be rounded to whole dollars. <br />NAME OF FILER <br />LATE CONTRIBUTION REPORT <br />o <br />Mike Soubirous for Riverside City Council - Ward 3 2013 <br />Date of <br />This 11/05/2013 <br />RECEIVE, iFORN1A <br />Filing <br />4 .97 <br />AREA CODE/PHONE NUMBER I.D. NUMBER (irappucable) <br />FORM <br />00 <br />1355581 <br />Report No. LCR- 201311 <br />4 j; l IJ — 5 2013 For Official Use Only <br />"' <br />S RE <br />El Amendment <br />City of Riversi e <br />a <br />to Report No. <br />City Clerk's Of ce <br />cITY <br />STATE ZIP CODE <br />(explain below) <br />Riverside CA <br />No. of Pages? <br />112 <br />n <br />Late Contribution(s) Received <br />C <br />DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR <br />RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) <br />IF AN INDIVIDUAL <br />ENTER IF AND EMPLOYER AMOUNT <br />CODE * <br />(IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED <br />11/04/2013 Mr. Frank Robles <br />� <br />IND <br />❑ C D <br />Retired 500.00 <br />� <br />Chatsworth CA <br />E3 OTH <br />❑ <br />1 <br />Co <br />ID: <br />PTY <br />❑ SCC <br />Co <br />❑ IND <br />❑ COM <br />❑ OTH <br />ID: <br />❑ PTY <br />❑ SCC <br />❑ IND <br />❑ COM <br />❑ OTH <br />1 <br />ID: <br />❑ PTY <br />o <br />❑ SCC <br />`�' <br />IV <br />O <br />W <br />'Contributor Codes <br />j <br />IND - Individual PTY - Political Party <br />W <br />COM - Recipient Committee (other than PTY or SCC) SCC - Small Contributor Committee <br />OTH - Other <br />fV <br />1� <br />W <br />Reason for Amendment: <br />0 <br />0 <br />Date Stamp FPPC Form 497(June/01) <br />0 <br />CD <br />N <br />FPPC Toll -Free Helpline: 866 /ASK -FPPC <br />
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