HomeMy WebLinkAboutSLO Citizens for Measure G - Form 497 - 10-09-14Report Type or print in ink.
497 Contribution Re
p Amounts may be rounded to whole dollars.
497 CONTRIBUTION REPORT
NAME OF FILER
Date of
Hate Stamp
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
SLID CITIZENS FOR MEASURE G
This Filing 10/9/2014
4
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
* ,
ar cial Use On ly
AREA CODEIPHONE NUMBER
I.D. NUMBER (ifappiicable)
RECEIVE D
OCT 0 9X014
805 - 544 -7774
1368735
Report No.
Amendment
STREET ADDRESS
1175 BUCHON STREET
to Report No.
(explain below)
�'�'' CITY C�i=�
1,000.00
CITY STATE ZIP CODE
SAN LUIS OBISPO CA 93401
No. of Pages
BUILDERS
❑ Check if Loan
1. Contribution(s) Received
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF - EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
GARY GROSSMAN
[X71 IND
PRESIDENT
10/8/2014
P.O. BOX 13
COM
COASTAL COMMUNITY
1,000.00
PISMO BEACH, CA 93448
❑ OTH
BUILDERS
❑ Check if Loan
❑ PTY
❑ SCC
%
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
El SCC
%
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
%
Provide interest rate
Reason forAmendment:
— Contributor Codes
IND — Individual
COM — Recipient Committee (other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 497 (March /2077)
FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275 -3772)