HomeMy WebLinkAbout2019-09-23 Form 497 - Woods497 Contribution Report
NAME OF FILER
Dennis W oods for P a lm S prings City Counc il Distric t 2 , 2019
Amounts may be rou nded to wh ole do llars.
Date of
This Fi ling 9/2 1/20 19 Date St amp CALIFORNIA 49 7
FORM RE CEI VED
Rep ort No. ___ 5 __ c_lT OF p II LH SPRING S AREA CODE/PH ONE NUMBER
(
I.D. NUMB ER /II applleable)
1419200
For O ffi cial Use Only
STREET ADDRESS
•Amendment
201 SEP 23 PM 2: 34
to Re p ort No. ----++8+-f "'-f I E O -C-IT_Y _________________ S_T_A-TE ___ Z_IP_C_O_D_E ____ ~ (explainbel ow) F THE CITY CLER !'
1
Palm S prings C A 92262 No. of Pages -----
1. C ontri bution(s) Receive d
DATE FULL NAME , STREET ADDRESS AND ZIP CODE OF CONTRI BUTOR CONTR IBUTOR
RECE IVE D (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CO DE·
Palm S prings Mode rn -H e ri tage F u nd 0 IND
PO Box 4 758 0 CO M
9/20/2019 Pa lm S pring s C A 92263 ~ 0 TH
0 PTY • sec
0 IND
0 COM
0 0 TH
0 PTY • sec
0 IND
0 COM
0 0TH
0 PTY • sec
Reason for Amendmen t: _______________________________ _
IF AN IND IVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(I F SELF-EMPLOYED. ENTER NAME OF BUSINESS)
• Contributor Code s
IND -Individual
AM OU NT
RECEIVED
5 ,000
D Check if Loa n
%
Prov,de lnteresl ra l e
D Ch eck if Loan
%
Provide interest ra le
D Check if Lo an
%
Provide interest ra te
COM -Reci pient Committee (o th er than PTY or SCC)
0TH -Other (e .g .. business entity)
PTY -Politic al Party
sec -Sma ll Contributor Committee
FPPC Form 497 (Feb /2019)
FPPC Advice: advi ce@fppc.ca.gov (866/275-3772)
www.fppc.ca.go v