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497 Ccs ibution Report Amounts ma, rounded to whole dollars. <br />NAME OF FILER <br />DI Po 1416m� 7 ze�) <br />Date of — z <br />This Filing <br />Date Stamp <br />ti <br />J� 0 In r c e f / q <br />Report No. <br />E] Amendment <br />wh" E(aN E I 1V E C <br />SEP 2 5 2019 <br />For Official Use Only <br />I& <br />AREA CODE/PHONE NUMBER <br />I.D. NUMBER (ifappiicabie) <br />STREETADDRESS <br />to Report No. <br />(explain below} <br />No. of Pages <br />My of Riverside <br />City C(eWs Office <br />CI STATE ZIP CODE <br />I Ile <br />F-1 OTH <br />E] PTY <br />0 Check if Loan <br />1. Contribution(s) Received <br />DATE <br />FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR <br />CONTRIBUTOR <br />IF AN INDIVIDUAL, <br />ENTER OCCUPATION AND EMPLOYER <br />AMOUNT <br />RECEIVED <br />(IF COMMITTEE, ALSO ENTER I.D. NUMBER) <br />CODE* <br />(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) <br />RECEIVED <br />IND <br />Z qCOM <br />F-1 OTH <br />E] PTY <br />0 Check if Loan <br />F-1 SCC <br />Provide interest rate <br />❑ IND <br />❑ COM <br />OTH <br />D Check if Loan <br />❑ PTY <br />El SCC <br />Provide interest rate <br />❑ IND <br />❑ COM <br />F-1 OTH <br />0 Check if Loan <br />El PTY <br />❑ SCC <br />—210 <br />Provide interest rate <br />* Contributor Codes <br />IND - Individual <br />COM - Recipient Committee (other than PTY or SCC) <br />OTH - Other (e.g., business entity) <br />Reason for Amendment: 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 />