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497 Contribution Report <br />Amounts may be rounded to whole dollars. <br />NAME OF FILER (�- S j c} <br />br LOI)iiw"� pe,Arr , Poi- Liar 7 2O ` l <br />Date ofa <br />This Filing 3_z' _1? <br />Date Stamp <br />� � � �� <br />RECEIVE <br />MAR 0 5 2019 <br />City of RiversideIti <br />City Clerk's Office <br />CALIFORNIA 49 7 <br />FORM <br />For Official Use Only <br />Report No. / <br />AREA CODE/PHONE NUMBER <br />I.D. NUMBER (if applicable) <br />IC} I 6 2 ?9 <br />El IND <br />❑COM <br />(:3 OTH <br />STREET ADDRESS <br />■ Amendment <br />to Report No <br />(explain below) <br />No. of Pages / <br />CITY <br />Q _� /I"TE ZIP CODE <br />i V '& 7 C/4 <br />■ SCC <br />1. Contribution(s) Received <br />DATE <br />RECEIVED <br />FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR <br />(IF COMMITTEE, ALSO ENTER I.D. NUMBER) <br />CONTRIBUTOR <br />CODE* <br />IF AN INDIVIDUAL, <br />ENTER OCCUPATION AND EMPLOYER <br />(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) <br />AMOUNT <br />RECEIVED <br />1-.3(9-1�y 1 <br />S)* TOve5 <br />_ ) /l.�A <br />R t v,o--S i <br />El IND <br />❑COM <br />(:3 OTH <br />j� k <br />Y� <br />i 2 y 00° <br />0 Check if Loan <br />■ PTY <br />■ SCC <br />Provide interest rate <br />❑ IND <br />• COM <br />❑ OTH <br />❑ Check if Loan <br />• PTY <br />❑ SCC <br />Provide interest rate <br />❑ IND <br />• COM <br />• OTH <br />❑ Check if Loan <br />❑ PTY <br />■ SCC <br />Provide interest rate <br />Reason for Amendment* <br />* Contributor Codes <br />IND - Individual <br />COM - Recipient Committee (other than PTY or SCC) <br />OTH - Other (e.g., business entity) <br />PTY - Political Party <br />SCC - Small Contributor Committee <br />FPPC Form 497 (Feb/2019) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />