2017-10-17 Form 497 - Middleton• 497 Contribution Report
Lisa Middleton for Palm Springs City Council 2017
• Amounts may be rounded to whole dollars.
Date of
This FIiing 10/16/2017
GlT
RECE\ V8[t\8mp
Of PALM SP~iHG ~--
•
C.'.\LIFORI,!"-497
FOR:\;l
AREA CODE/PHONE NUMBER I.D. NUMBER (If apptlcable} Report No. Form 49.7 lt QCT \ 1. PH 4: 19 ( 1394265 111016 21
(axplainbetow) '1
For Official Use Only
CITY
Palm Springs
STATE
CA
ZIP CODE
92264 No.of Pages
1. Contributions Received
DATE
RECEIVED
10/13/2017
10/13/2017
10/13/2017
Reason for Amendment:
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTR!BUTOR
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
Keasler Property
275 Camino Norte
Palm Springs, CA 92262-4209
Palm Springs Police Officers Association PAC
1121 L St
Ste 200
Sacramento, CA 95814-3970
ID: 951841
Riverside County Democratic Central
Committee
5429 Madison Ave
Sacramento, CA 95841-3111
ID: 1342861
1
CONTRIBUTOR
cooE·
•IND •COM
00TH
OPTY •sec
01ND
0COM
DOTH
OPTY •sec
•IND •COM
DOTH
0PTY •sec
------------------------------------
IF AN INDIVIDUAL,
ENTER OCCUPATION ANO EMPLOYER
OF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
*Contributor Codes
IND • Individual
AMOUNT
RECEIVED
$1,000.00
D Check if Loan
% == ....... ==--Provide interest rate
$1,433.00
D Check if Loan
'."¾
Provide ir"llerest rate
$1,000.00 •Check if Loan
COM -Recipient Committee (other than PTY or SCC)
0TH • other (e .g., business entity)
PTY • Political Party
sec -Small Contributor Committee
FPPC Form 497 (Jult201 B>
FPPC Advice: adYlce@fppc.ca.gov (8161271-3772) www.fppc.ca.gov