HomeMy WebLinkAbout803 Robert Moon 2019-04-18 Harold MatznerBehested Payment Report
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A Public Doc~mae n t p • L~~ s~" .i
1. Elected Officer or
Mco.u 2018
Agency Name For Official Use Only
C,
Agency Street Address
~ ---. 020<.:J E;.. l tfc:;)L) 11?
Designated Contact Pe~ame and title, if different)
'-ul!-~ Mc.tJAJ
D Amendment (See Part 5)
Area Code/Phone Number E-mail (Optional) Date of Origi nal F i li ng: ______ _
760 · ~2s . 32-cV ruber-t/ rv"\l.O'I ~ (month, day. year)
2. Payor Information (For additional payors, include an attachment with the names and addresses .)
lkt..D M lf('cf)el
Address State Zip Code
3. Payee Information (For additio nal payees, include an attachm ent with the names and addresses.)
~ LM S;,fo ~ ~ A~.se.1<.,M.) l.E4-tcJ.v ¾.s1 5 /~
Name
4W )J.
Address City State Zip Code
4. Payment Information (Comple te all Information.)
Date of Payment: '-IU~ /Z-018 Amount of Payment : (ln-KindFMV) $ /GV, <..Vo,cltJ
(m6nth, dJy,~ (Ro und lo whole dollars .)
Payment Type : [91\i'lone tary Do nation or D In-Kind Goods or Se rvi ces (Provide description below.)
Brief Description of In-Kind Payment: -----------------------------
Purpose : (Check one and pro vide description below.) • Legislative • Governmental
Describe the legislative , governmental , charitable purpose, or event: ti'--11
6-;-5/ 7 tfciv{Je .S Se,v;c.r_::, J sr..-,_f-rb 1..'.h....--/4u /
5. Amendment Description and/or Comments
6. Verification
I cert ify, unde r penalty of perjury under th e la ws of the S
herein is true and complete .
Ex ec uted on _ __,,O~~~~/----'f'-Af-e .... 1/_2-0_!_B_
be st of my knowl edge , the inform ation cont aine d
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline : 866/ASK-FPPC (866/27S-3772)