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497 Melendrez MYR (02-12-20)_R
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x <br />M <br />M <br />0 <br />Ili <br />C) <br />M <br />C3 <br />Amounts maybe rounded to whole dollars. <br />497 CONTRIBUTION REPORT <br />NAME.OF FILER <br />Date of <br />Date Stamp <br />IF AN INDIVIDUAL, <br />ENTER OCCUPATION AND EMPLOYER <br />Andy Melendrez for Mayor 2020 <br />This Filing — 02/-11/2020 <br />(IF COMMITTEE, ALSO ENTERI.D. NUMBER) <br />CODE <br />AREA GODE/PHONE NUMBER <br />I.D. NUMBER (irapplical5fe) <br />For Oficial Use Only <br />Ersam Ibrahim <br />11421003 <br />Report No. 15 <br />11000.00 <br />IND <br />Essam Ibrahim, DDS <br />FEB 1 2.2o2o <br />STREET ADDRESS <br />El COM <br />Amendment <br />to Report No. <br />(explainbelow) <br />city of Riv,.-" <br />Cit� <br />0 Check if Loan <br />CITY STATE ZIP -CODE <br />No. of Pages <br />Clerk,,s x <br />Riverside CA <br />El SCC <br />M <br />DATE <br />FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR <br />CONTRIBUTOR <br />IF AN INDIVIDUAL, <br />ENTER OCCUPATION AND EMPLOYER <br />AMOUNT <br />RECEIVED <br />(IF COMMITTEE, ALSO ENTERI.D. NUMBER) <br />CODE <br />(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) <br />RECEIVED <br />02/11/2020 <br />Ersam Ibrahim <br />Dentist <br />11000.00 <br />IND <br />Essam Ibrahim, DDS <br />Riverside, CA <br />El COM <br />El OTH <br />0 Check if Loan <br />El PTY <br />El SCC <br />Pfovide interest rate <br />IND <br />com <br />El OTH <br />0 Check if Loan <br />[I PTY <br />El SCC <br />Provide interest rate <br />El IND <br />El COM <br />[:] OTH <br />[I Check if Loan <br />El PTY <br />El 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 (8661275-3772) <br />E__ <br />Qj <br />r\) <br />0 <br />C) <br />(D <br />4�- <br />00 <br />I <br />
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