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497 Contribution Report
(213) 452-6565
STREETADDRESS
777 S. Figueroa St. Suite 4050
CITY
Los Angeles
1. Contributions Received
Amounts may be rounded to whole dollars.
1401010
STATE ZIP CODE
CA 90017
✓❑Amendment
to Report No. x
(explain below)
No. of Pagas 2
RFCFIV; .-
uC1Li'`F r-i11 L
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND AP CODE OF CONTRIBUTOR
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE'
IF AN INDIVIDUAL.
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
❑ IND
Altamira Vacation Rentals, LLC
❑COM
$1,000.00
04/07/2018
611 S Palm Canyon Dr
❑✓OTH
❑Check It Loan
# 7-528
❑PTY
rNMEW
Palm Springs, CA 92264-7213
❑SCC
Provide%
❑ IND
❑COM
$1,000.00
Casa De Monte Vista LLC
✓❑OTH
❑Check If Loan
04/08/2018
696 N Via Monte Vis
Palm Springs, CA 92262-4330
❑PTY
:� a �%
[]SCC
Provide Interest rate
Q IND
Kent Korneisel
❑COM
Optometrist
$2,500-00
04/07/2018
3500 N 18th St
❑OTH
Dr. Kenny Louie &
[]Check if Loan
Tacoma, WA 98906-5702,._
❑PTY
Associates, PC'-'`x'r`
;q6
[:]SCC
Provide inleresl rate
Reason for Amendment. Contributions Amended.
'Contributor Codes
IND - Individual
COM - Recipient Committee (other than PTY or SCC)
OTH - Other (e.p bssinew entity)
PTY - Poltiw! Patty
SCC - Small Conbibula Commillee
FPPC Farm 497 (JuU2019)
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