HomeMy WebLinkAboutdocument (59)497 Contribution ReportType or print in ink.Amounts may be rounded to whole dollars.AMOUNTRECEIVEDIF AN INDIVIDUAL,ENTER OCCUPATION AND EMPLOYER(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)DATERECEIVED497 CONTRIBUTION REPORTCALIFORNIAFORMDate StampFULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR(IF COMMITTEE, ALSO ENTER I.D. NUMBER)CONTRIBUTORCODE*For Official Use Only497NAME OF FILERAREA CODE/PHONE NUMBERSTREET ADDRESSCITY STATE ZIP CODEI.D. NUMBER (if applicable)1. Contribution(s) ReceivedINDCOMOTHPTYSCCDate ofThis Filing Report No. Amendmentto Report No. No. of Pages FPPC Form 497 (March/2011)FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)INDCOMOTHPTYSCCINDCOMOTHPTYSCC*Contributor CodesIND – IndividualCOM – Recipient Committee (other than PTY or SCC)OTH – Other (e.g., business entity)PTY – Political PartySCC – Small Contributor Committee(explain below)Reason for Amendment: Check if Loan%Provide interest rateCheck if Loan%Provide interest rateCheck if Loan%Provide interest ratewww.netfile.comCarey Davis for Mayor 2014(909)648-58271357926San BernardinoCA9240401/31/201414-17101/31/2014David MlynarskiSan Bernardino, CA 92408XPrincipalTranstech/Mapco3,500.00E-Filed01/31/201415:52:03Filing ID:149439823