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edule C <br />°monetary Contributions Received <br />SEE ENSTRUCfONSON1.REVERSE <br />NAME OF HLEi <br />Amounts rl:ay be rounded <br />to whole dollars. <br />Stalumment covers period <br />from <br />—2 <br />througis. ` � <br />CALIFORNIA <br />FOR i <br />DATE <br />HCl 5315 l <br />328-wi4 <br />FULL NAIAE,SIREETADDRESSAND <br />ZIP COPE OF CQNTRIMITOR <br />(iFtO i r: ,A Err RL%L WARM) <br />L i i= Pace, <br />Ash additional infanna€ion on appy <br />CQN RIBUTO <br />CODE * <br />d COM <br />d OTH <br />d FTY <br />D cIj <br />0 COM <br />d OTH <br />0PT'Y <br />0 S <br />d IND <br />d COM <br />Dom <br />ome <br />d SCG <br />d u.0 <br />d COM <br />d CATH <br />❑P`? <br />D scc <br />iFAMNDIVIO LAi.,.strreR <br />O0CUPA11OHAND EMPLOYER <br />kiF <br />seLF,EuELDYMOTER <br />N MEQ-Gauate 5} <br />bESCI tPT oN OF <br />GOODS OR SERVICES <br />AMOUNTI <br />FANR.MARKET <br />VALUE <br />qumu mE TO <br />DACE <br />• CALENDAR YEAR <br />(JAN 1 - DEC 31) <br />PER Ei Er 1ON <br />TO DATE <br />(W REQUIRED) <br />labeled continuation sheets. <br />Schedule G Summary <br />1. Amount roved this period — itemized nonmonetaty contributions. <br />(include ani Sct'Eedrf)e.Osubt Is.... T 1S <br />2. Amount received this >period .. unitemized..nonmonetary contributions of less then $100 <br />3. Totai nonmonetary corrtdbutions rived this pe rod. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) _ <br />@ 0 <br />TOTAL. $' <br />If *Contributor Cadts <br />IND — individual <br />COM' Recipient Cc►r ittee <br />(other than PTY or SCC} <br />OTH -- other (e.g, business entity) <br />PTY- Political Party <br />BCC- S ali. Contributor Committee <br />FPPC Form 460 pan/20161 <br />FPPC Advice; advice@fppc.ca.goy (266/275-3772) <br />wwwippc.ca.gov <br />